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Table 3 CFIR domains and constructs per theme; barriers and facilitators

From: Implementation of a standard outcome set in perinatal care: a qualitative analysis of barriers and facilitators from all stakeholder perspectives

Theme Subthemes (facilitators and barriers) CFIR elements identified (domains; constructs)
Instrument and process factors Enabling: complete set; international consensus; instructions; effect proof; feedback professionals; patient engagement; combine registrations; interdisciplinary; leadership; IT-system Intervention characteristics: intervention source, evidence strength, relative advantage, trialability, complexity, costs
Outer setting: patient needs and resources, peer pressure
Inner setting: implementation climate, readiness for implementation
Individual characteristics: knowledge and beliefs, individual stage of change
Process: planning, engaging
Impeding: international consensus; effectivity; abstract; patient burden; resistance to change; professionals’ workload; lack of prioritizing; privacy; IT-system; costs
Use in individual patient care Enabling: patients’ benefits; time gain individual reaction; more unity Intervention characteristics: relative advantage, complexity
Outer setting: patient needs and resources
Inner setting: implementation climate, readiness for implementation
Individual characteristics: self-efficacy
Impeding: PREM misinterpretation; professionals’ responsibility
Use in quality improvement Enabling: measures reflect goals; less fragmentation; motivation; improve quality; learn from benchmark; external policy Intervention characteristics: relative advantage, complexity, cost
Outer setting: patient needs and resources, external policy
Inner setting: culture, implementation climate
Individual characteristics: knowledge and beliefs about the intervention
Impeding: data reliability; current QI; perceived influence; measures too general; transparency; scepticism PREMs
Context of OCN Enabling: local collaboration; trust; communication structures; more unity; integrated care Intervention characteristics: relative advantage, complexity, cost
Inner setting: structural characteristic, networks and communication, culture, implementation climate
Individual characteristics: individual identification with organization
Impeding: collaboration structure; financial incentives; interdisciplinary relations
  1. Legend: OCN Obstetric care network; QI Quality improvement; T5 = measurement moment at six months postpartum
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