Domains | Themes | |
---|---|---|
Facilitators | Barriers | |
 | Start-up Stage | |
Strategies | 1. Availability of needs assessment 2. Intensive training | 1. Incomplete needs assessment 2. Training challenges 3. Systems and technology incompatibility |
Capability | 1. Robust service capacity 2. Experience and Expertise | 1. Limited service capacity |
Relationships | 1. Existing relationship | 1. Lack of close relationship 2. Referral patterns limitation |
Environment | Â | 1. Competition 2. Politics and contextual issues |
 | Utilization Stage | |
Strategies | 1. Intensive training 2. System and technology enhancement 3. Champions’ availability 4. Adequate staffing 5. Marketing plan 6. Adaptation of TeleED workflow | 1. Training challenges 2. System and technology incompatibility 3. Champions’ absence 4. Staffing turnover |
Capability | 1. Robust service capacity 2. Experience and Expertise | 1. Limited service capacity 2. Lack of utilization |
Protocols | 1. Well-defined workflow | 1. Workflow flaws 2. Referral process limitation |
Service Characteristics | 1. Responsiveness 2. Care coordination 3. Assist with transfer 4. Meeting the needs 5. Video call benefits | 1. Time-consuming process |
Relationships | 1. Close relationship 2. Enhancing existing relationship | 1. Lack of buy-in 2. Locums not being on board |
Financials | 1. Contracting 2. Grant funding 3. Reimbursements | Â |
Environment | Â | 1. Lack of integration 2. Culture of transfer 3. Lack of awareness |
 | Sustainment Stage | |
Strategies | 1. Fit with needed service 2. Opportunities 3. Plan in place | 1. Poor fit with needed service |
Capability | 1. Availability of multi-specialties 2. Availability of multiple services | 1. Lack of multi-specialties 2. Lack of utilization 3. Lack of full-time ED physician 4. Lack of placement options 5. Poor attrition |
Financials | 1. Payment model 2. Contracting 3. Low cost of equipment | 1. Payment model flaws 2. Reliance on grant funding 3. Not a money-maker |
Accountability | 1. Evaluation and quality improvement 2. Learning from the experience | 1. Lack of evaluation measures |
Relationships | 1. Referral patterns 2. Network resources | Â |
Environment | Â | 1. Interfering politics and contextual issues |