Table 4 Barriers and facilitators mentioned in focus groups
Acute care chain | Barrier | Facilitator |
|---|---|---|
Implementation care chain (acute abdominal complaints) | Routines | Routines |
- Work routines differ between organizations involved in the care chain | ||
- Feedback is not provided formally yet | ||
- Providing feedback is not a work routine | ||
- A non-electronic form differs from current routines, as electronic systems are used | ||
- Procedures of information transfer and feedback are absent | ||
Organization | Organization | |
- There is no coordination of the acute care chain | - The redesign should fit into the organization’s policy | |
Sense of urgency | Sense of urgency | |
- In practice, the sense of urgency might have been very low | - On a higher organizational level, there was a sense of urgency for improvement | |
Implementation methods | ||
- Top down implementation approach | ||
- Implementation during holiday season | ||
- Features of the redesign itself | ||
Other factors | Other factors | |
- Practical experience shows that care providers were not willing to work according to the redesign | - The redesign is desirable | |
Control care chains* (acute hip traumas, acute psychiatric care, CVA) | Routines | Routines |
- Work routines differ between districts and organizations involved in the care chain | ||
- The redesign differs from the current work routines | ||
- Organizations are used to work with digital systems instead of paperwork. | ||
Organization | Organization | |
- There is no coordination of the acute care chain | - The redesign should fit into the organization’s policy | |
Sense of urgency | Sense of urgency | |
- A need for improvement in information transfer and feedback is experienced, although may not be very urgent | ||
Implementation methods | ||
- Top down implementation approach | ||
- Implementation during holiday season | ||
- Features of the redesign itself | ||
Other factors | Other factors | |
- Willingness to work with the redesign depends on whether it is digital or not. As a paper version, willingness would not be very high | - The ideas behind the redesign are probably desirable |