Table 1 Barriers and Facilitators to Guideline Concordant Acute Stroke Treatment described via a Tailored Implementation in Chronic Disease (TICD) framework analysis
TICD Domain | Barrier or Facilitator | Construct |
|---|---|---|
Guideline Factors | Barrier | Strength of recommendation |
Quality of Evidence Supporting the Recommendation | ||
Effort | ||
Clarity | ||
Observability | ||
Compatibility | ||
Facilitator | Accessibility of the Intervention | |
Accessibility of the Recommendation | ||
Trialability | ||
Individual Healthcare Professional Factors | Barrier | Emotions |
Intention and motivation | ||
Self-monitoring or feedback | ||
Agreement with the Recommendation | ||
Domain Knowledge | ||
Health care professional burnout* | ||
Facilitator | Self-Efficacy | |
Awareness & familiarity with the recommendation | ||
Expected Outcome | ||
Patient Factors | Barrier | Patient needs |
Patient behavior | ||
Patient beliefs and knowledge | ||
Patient preferences | ||
Surrogate decision makers* | ||
Professional Interactions | Barrier | Referral processes |
Facilitator | Communication & Influence | |
Incentives and Resources | Barrier | Availability of necessary resources |
Health care professional turnover* | ||
Facilitator | Quality Assurance & Patient Safety Systems | |
Assistance for Clinicians | ||
Continuing Education System | ||
Capacity for Organizational Change | Barrier | Monitoring and feedback |
Regulations, rules, policies | ||
Facilitator | Capable Leadership | |
Guideline Factors | Barrier | Strength of recommendation |
Quality of Evidence Supporting the Recommendation | ||
Effort | ||
Clarity | ||
Observability | ||
Compatibility | ||
Facilitator | Accessibility of the Intervention | |
Accessibility of the Recommendation | ||
Trialability | ||
Individual Healthcare Professional Factors | Barrier | Emotions |
Intention and motivation | ||
Self-monitoring or feedback | ||
Agreement with the Recommendation | ||
Domain Knowledge | ||
Health care professional burnout* | ||
Facilitator | Self-Efficacy | |
Awareness & familiarity with the recommendation | ||
Expected Outcome | ||
Patient Factors | Barrier | Patient needs |
Patient behavior | ||
Patient beliefs and knowledge | ||
Patient preferences | ||
Surrogate decision makers* | ||
Professional Interactions | Barrier | Referral processes |
Facilitator | Communication & Influence | |
Incentives and Resources | Barrier | Availability of necessary resources |
Health care professional turnover* | ||
Facilitator | Quality Assurance & Patient Safety Systems | |
Assistance for Clinicians | ||
Continuing Education System | ||
Capacity for Organizational Change | Barrier | Monitoring and feedback |
Regulations, rules, policies | ||
Facilitator | Capable Leadership |