Table 2 CFIR Domain - Innovation Characteristics

Intervention source

F

The intervention came from within the organization, it was an internally developed workflow checklist, not from outside policy makers or regulatory bodies.

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Evidence, strength & quality

F

The intervention came from a trusted internal source and from an expert group with awareness of local needs. Though guided by literature from previous epidemics, there was little peer-reviewed evidence of what exactly was needed to promote effectiveness.

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Relative advantage

F

National guidelines and recommendations for managing obstetric COVID-19 patients were collected, synthesised, and disseminated among the stakeholders; however, there was wide variety of interpretation as to the implementation of these in practice. Implementing a sequential checklist was perceived to be faster at producing alignment.

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Adaptability

F

The ability to adapt the innovation to the local obstetric context was clear. Input from multiple disciplines (OB, anesthesia, nursing, NICU) were involved in deciding whether changes were needed to the intervention.

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Trialability

F

Immediate testing was possible. The intervention was used during real cases with the ability to reverse the implementation if required.

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Complexity

B

The workflow was felt to be very complex, involved several aspects of care that were not intuitive and required several iterations to improve performance. It required extra staff members for implementation compared to routine care, which was perceived as a further complication that may have hindered adoption, in particular if staffing levels were low..

0

Design Quality & Packaging

F

The initial reception of the innovation was positive and the quality perceived to be high.

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Cost

F

The cost of implementation was the additional manpower needed to ensure the checklist was being followed as the many steps would be impossible to memorise in a short period of time.

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