Table 3 Selected key findings assessed as barriers and facilitators for clinical quality registry implementation, organized by domains in the Consolidated Framework for Implementation Research (CFIR)

Intervention characteristics

Practice changes often required but not foreseen.

Ambiguity of registry variables.

Poor registry design/functioning with regards to e.g. patient follow-ups.

Poorly functioning data linkage.

Typing on computer screen diverts attention from patient.

Continuous development and adjustment of registry function and content, as needed.

User-friendly layout and design.

Inner setting & Outer setting

Lack of management support in data collection and entry phase.

Lack of incentives.

Management interest in output data (results).

Feedback data regarding local use of resources and local quality.

Use of registry included in cardiac rehabilitation certification programme.

Mandated participation in registry.

Results part of national quality indicators.

The prospect of improving patient care and raising acknowledgement for cardiac rehabilitation.

A culture of data reporting.

Process

Lack of formal planning of implementation process.

Implementation a responsibility of the individual clinician (or few clinicians).

Lack of support and clarification.

Training and support of users.

Characteristics of individuals

Lack of knowledge about purpose of the registry.

Lack of know-how and resources to use data for local quality improvement.

Local registry advocates/ champions.