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Table 4 Qualitative content analysis of key informant interviews—individual domain of the Consolidated Framework for Implementation Research (CFIR)

From: Intervention, individual, and contextual determinants to high adherence to structured family-centered rounds: a national multi-site mixed methods study

Individual domain qualitative content analysis themes

Facilitators

Construct

 Relatively consistent beliefs regarding which components of family-centered rounds (FCR) are most important

Knowledge and beliefs

 Belief that structured FCR approaches like I-PASS SCORE increase care team and family understanding of the care plan

Knowledge and beliefs

 Belief that structured FCR approaches like I-PASS SCORE provides a forum for families to express concerns and to feel engaged and empowered to participate in their child’s care

Knowledge and beliefs

 Belief that structured FCR approaches like I-PASS SCORE demonstrate respect for the family’s role and increases family awareness of the healthcare team and their connection to the team

Knowledge and beliefs

 Belief that structured FCR approaches like I-PASS SCORE provide a structure for rounds that benefits the care team, including resident learners

Knowledge and beliefs

 Belief that structured FCR approaches like I-PASS SCORE take longer but efficiencies are gained throughout the day with fewer follow up questions regarding the plan

Knowledge and beliefs

 Belief that structured FCR approaches like I-PASS SCORE increase patient and family overall satisfaction with care

Knowledge and beliefs

 Belief that structured FCR approaches like I-PASS SCORE improve care outcomes

Knowledge and beliefs

 Participants express a high level of confidence in their ability to follow structured FCR approaches like I-PASS SCORE

Self-efficacy

 Some individuals intend to use structured FCR approaches like I-PASS SCORE going forward in their practice

Stage of change

 Participants have high confidence that the organization will continue to use structured FCR approaches like I-PASS SCORE when the project is complete

Stage of change

Barriers

 Variation in beliefs about the purpose of rounds across stakeholders

Knowledge and beliefs

 Physician with more experience may be less willing to adhere to more structured approaches.

Personal attributes

 Nurses may not believe their attendance on rounds is a priority for the team (e.g., they are not actively included in rounds) and not a good use of their time.

Knowledge and beliefs

 Nurses believe they can address questions regarding the care plan with physicians more efficiently at other times

Knowledge and beliefs

 Family cultural norms (role of authority figures, et al.) effect their level of participation during rounds

Personal attributes

 Presenters/learners do not want to appear “wrong” in front of peers and families

Self-efficacy

 Belief by some participants that family presence and emphasis on use of plain language can limit content discussed during rounds.

Knowledge and beliefs

  1. List of frequent or compelling individual determinants identified through field interview to organization implementation of a structured FCR approach