Table 4 Identification of Facilitators and Hindrances for the Implementation of the PPC Role
CFIR Domain | Construct within Domain | Constructs and their Explanation | PPC | Manager | HCP |
|---|---|---|---|---|---|
Outer Setting | Patient Needs & Resources | Facilitators: HCP: Supportive to patient and patient’s family needs. Indirectly impact the experience of patients and families. | ✓ | ||
Hindrances: HCP: Lack of sustainable resources. | ✓ | ||||
External Policies and Incentives | Facilitators: HCP: Policies from external agencies – e.g., Ministry of Health regarding the pandemic. | ✓ | ✓ | ||
Hindrances: HCP: Insufficient resources/ detail from province. | ✓ | ||||
PPC: Lack of synchronization of information and timing, and fear of different information from news agencies in the pandemic. | ✓ | ||||
Cosmopolitanism | Facilitator: HCP: External benchmarking done at hospital. | ✓ | |||
Inner Setting | Structural Characteristics | Facilitator: HCP: Central office. | ✓ | ✓ | |
Hindrances: HCP: Lack of role clarity/awareness/recognition/ introduction to role. Unknown as to accountability in the organization structure. | ✓ | ||||
Manager: Challenges adapting to multiple settings within the organization | ✓ | ✓ | |||
Availability of Resources | Facilitators: HCP: Voicera phones | ✓ | ✓ | ✓ | |
HCP: Educational/ Training Sessions. | ✓ | ✓ | |||
PPC: Educational materials/ binders/ handouts. | ✓ | ||||
HCP: Email Communications/ local telephone. | ✓ | ✓ | |||
Covid website. PPC: Data base for questions. | ✓ | ✓ | |||
HCP: Signage. | ✓ | ✓ | |||
Networks & Communications | Facilitators: HCP: Informal communication. Centralized source of information. | ✓ | |||
Consolidating information. Confirming, clarifying, asking questioning | ✓ | ||||
Communicating with staff during Huddles/ Rounds. | ✓ | ||||
PPC: Access to key people. | ✓ | ||||
Manager: Disseminating information. | ✓ | ||||
Hindrances: Manager: Variability in communication styles. | ✓ | ||||
HCP: Inconsistency in communication for HCP. Information overload. | ✓ | ||||
Facilitator and Hindrance: HCP: Training available but insufficient for formal PPC role. | ✓ | ||||
Culture | Facilitators: HCP: Culture of Openness to Change. | ✓ | |||
Supportive unit culture. | ✓ | ✓ | ✓ | ||
PPC: Staff are open to change, culture of safety, earning. | ✓ | ||||
Hindrances: HCP: Acute care culture that lacked adaptability. | ✓ | ||||
Facilitators: HCP: Culture of Excellence. | ✓ | ||||
PPC: Amazing work that trickles through the organization. | ✓ | ||||
Manager: Impact on practice change, organizational responsiveness, innovation, and adaptability. | ✓ | ✓ | ✓ | ||
Implementation Climate | Hindrances: HCP: Tension for change. | ✓ | |||
PPC: Poor attitude towards change. | ✓ | ||||
Manager: Contention and disagreement on how to move forward. | ✓ | ||||
Hindrances: HCP: Compatibility. | ✓ | ||||
Lack of buy-in from some staff in some areas, hostile responses at times. | ✓ | ✓ | |||
Facilitators: PPC: Overall, PPC well received. | ✓ | ||||
MG: Compatible with roles and initiatives. | ✓ | ✓ | |||
Hindrances: HCP: Relative Priority. | ✓ | ||||
Manager: Competing priorities with care needs. | ✓ | ✓ | ✓ | ||
HCP: Organizational Incentives and Rewards. | ✓ | ||||
Facilitators: HCP: Learning climate. | ✓ | ||||
Openness to learning and implementation. | ✓ | ✓ | ✓ | ||
Hindrances: HCP: Some units more receptive than others. | ✓ | ✓ | ✓ | ||
HCP: Time. | ✓ | ✓ | ✓ | ||
PPC: Inability to connect with people resources in timely manner. | ✓ | ||||
Manager: Insufficient time to getting the word out. | ✓ | ||||
HCP: Pandemic fatigue and unfamiliarity. | ✓ | ||||
Facilitators: HCP: Goals and Feedback. | ✓ | ||||
MG: Similar goals to other roles and initiatives. | ✓ | ||||
Readiness for Implementation | Facilitators: HCP: Leadership Engagement/ Support | ✓ | |||
PPC: Leadership mentors available. | ✓ | ||||
MG: Leadership involvement with PPC role development. | ✓ | ✓ | |||
Ready for the PPC role. | ✓ | ||||
HCP: Access to Knowledge and Information. | ✓ |