Multi-factorial barriers and facilitators to high adherence to lung-protective ventilation using a computerized protocol: a mixed methods study

Table 5 Qualitative content analysis of key informant interviews—inner setting Consolidated Framework for Implementation Research domain

Qualitative content analysis themes	Clinician type	Relevant topic	Site adherence
Facilitator or barrier
Perception that use of LPV and the LPV CDS tool is a system-level, top-down mandate	RT, P	LPV, CDS	L, M, H
Frequent discussions between team members regarding the use of the LPV CDS protocols	RT	CDS	L, M, H
Barrier
Resentment that clinicians have limited autonomy regarding selection strategies for specific patients	RT, P	LPV	L, M
Lack of clarity at all organization levels about the definition of success using LPV and LPV CDS tool	RT, P	LPV, CDS	L, M
Local site clinical leaders take limited accountability for improvement	RT, P	LPV	L
Local opponents had a meaningful impact on general attitudes regarding the system approach to LPV and the LPV CDS tool	RT, P	LPV, CDS	L
Limited formal training was provided to assist users in using the protocols correctly	RT, P	CDS	L, M, H
Perception that there was no conveniently accessible place to obtain consistent answers to questions on LPV CDS tool	RT	CDS	L, M
Perception that additional lab tests are required to run the LPV CDS tool	RT	CDS	L

Type—respiratory therapist (RT) and physician (P); relevant topic—lung-protective ventilation (LPV) and clinical decision support (CDS) tool; site adherence—low (L), medium (M), and high (H)

ISSN: 2662-2211