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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)

From: “Struggling with practices” – a qualitative study of factors influencing the implementation of clinical quality registries for cardiac rehabilitation in England and Denmark

CFIR domain Barriers Facilitators
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.