Inner setting domain qualitative content analysis themes | |
---|---|
Facilitators | Construct |
 Structured FCR approaches like I-PASS SCORE align with the values and culture of the organization | Culture |
 Leadership support for structured FCR is strong with physician, nurse and patient experience leaders | Leadership support |
Barriers | |
 Sites stopped doing certain structured FCR components in response to the COVID-19 pandemic | Implementation climate |
 Lack of standardization in approach despite the presence of a structured FCR approach like I-PASS SCORE across attendings | Compatibility |
 Subspecialists often make care plans without including the rest of the patient care team | Networks and communications |
 Nurse participation on rounds is often subject to availability and competing patient priorities during rounding times | Compatibility |
 Structured FCR approaches like I-PASS SCORE disrupt existing clinical workflows requiring redesign, particularly for nurses | Compatibility |
 Nurse staff not properly resourced to support structured FCR approaches like I-PASS SCORE | Available resources |
 Nurses utilize workaround methods to accomplish the goals of structured FCR while limiting their time participating | Compatibility |
 Ongoing schedule changes lead to regular adjustments in team composition that impact rounding team development and performance | Compatibility |
 Rounding schedules may not allow families to attend rounds | Compatibility |
 Lack of resources as well as cultural barriers limit participation of limited English proficient families during rounds | Available resources |