Table 2 Summary of Barriers and Facilitators to Implementation
Result | Impacted Stage of Feedback Loop | ||
|---|---|---|---|
Audit | Feedback | Response | |
Intervention Characteristics | |||
 Cycle Frequency. FHTs felt that they did not have enough time to develop or implement QI initiatives between iterations of the feedback report. |  |  | B |
 Data Validity. Measures were insensitive to team behaviour. Data were not reflective of current performance due to duplication from other reports and reliance on administrative data. Technical definitions were unclear to informants. |  |  | B |
 Design. Visualizations were difficult to interpret; the website was hard to navigate and lacked functionality to print or share the feedback report. |  | B | B |
Outer Setting | |||
 QIDSS Dependence. QIDSS were the implementation leaders of D2D, with many practices dependent on this resource. | F | F | B |
Inner Setting | |||
 Relative Priority. Participation in other A&F programs influenced the priority of D2D. |  |  | B |
 Resource Requirements. D2D audit was considered to be labour intensive; FHTs lacked staffing to support further implementation. | B |  | B |
 Team Relationship. Physicians saw the FHT as an entity to which they were not accountable. |  |  | B |