i-PARIHS construct | Themes (i-PARIHS sub-construct [17]) | Quotes |
---|---|---|
Innovation | • CCM empowers providers to better navigate the system to help meet patient needs (relative advantage of the innovation) | “I think I know a little bit more how the other professions operate so I can kind of tell them how to prep the patient and maybe make some assumptions and really kind of give them more warm handoffs.” (Participant 804) |
• There is a need for more clarity around what care delivery processes embody CCM principles (usability of the innovation) | “I mean I think if there was a little more structure and guidance … maybe not policy but more procedure on how to do things, then people might feel a little more comfortable with it instead of just free floating, do whatever you want for 90 min [of team meeting] kind of thing.” (Participant 104) | |
Recipients | • Interdisciplinary collaboration and communication on the CCM team improved during the recipients’ participation in this project (collaboration and teamwork among recipients) | “… we kind of know each of our strengths and weaknesses, [are] working together so that we’re not having to assess the [same patient] five times, and reduce inefficiencies and play on all our strengths.” (Participant 804) |
• Changing the recipients’ practice norms was considered challenging (attitude of recipients toward the innovation) | “Unless their standard operating procedures are written, no, [they’re not] going to do it this way, they're going to do it the way they've always done it.” (Participant 101) | |
Context | • Engaging other clinical services for care process changes associated with implementation is challenging (networks and relationships influencing implementation) | “… in our clinic, primary care and mental health [services] just don’t get along really well. … we had [representatives] from primary care come [to] meet with us [and] work together but we still seem to hit some barriers and roadblocks with the integration of the two services.” (Participant 205) |
• CCM being a national recommendation serves as an impetus for local implementation (policies and priorities influencing implementation) | “… a recommendation that came out [from meeting with national leadership] … was that we were supposed to be in [CCM-based] teams and we were not.” (Participant 102) | |
Facilitation | • External facilitators help set reasonable expectations and are responsive to inquiries (planning/preparing for implementation) | “Our external facilitator came in and kind of gave us some more direction, kind of cleared a path for what we really need to be focusing on and I think now we have a better understanding and we’re more geared toward those goals.” (Participant 304) |
• Internal facilitators’ experience with quality improvement and team/process skills is valuable (using interpersonal skills to create a supportive environment) | “I really appreciated how [the team meeting] was run because I know having many people on a team, there’s different perspective, [so it] can also be difficult to keep things on track.” (Participant 912) |