Table 2 Examples of resource-climate interactions at group 2 clinical sites
Available resources | Implementation climate | Interplay | Phase | Illustrative quote |
|---|---|---|---|---|
Staffing (more staff were involved, but no dedicated staff/time) | Compatibility and relative priority (integration of the dashboard into existing workflows) | Staffing (↑) → climate (≈) More staff were involved in the intervention from implementation to sustainment phases due to their facility policy; however, the staff could not always get to the intervention because they had to juggle too many other dashboards. The interviewee suggested that having a dedicated group and dedicated time for intervention might help resolve the problem | Sustainment | “it was in the fall of 2016 when we started to use it and it was really just me using it as the anticoagulation program manager… as we have more and more patients switched to a DOAC, it needs to be a multiple person you know job, not just me because I wasn’t keeping up with it as I should have and since 2016, there’s been several more columns and types of flags added too, which is helpful in identifying those patients that may require a re-evaluation of dose or the critical drug interaction… something like that.” “… we may not always get to the DOAC dashboard every week because we have so many other dashboards to be using and addressing for population management. So, I think myself in our group, we would prefer to have a separate anticoagulation pharmacist group and a separate PACT pharmacist group so that we could manage these dashboards a little bit better and more effectively and efficiently.” Site 28, Study ID 118 |
Time (staff’s downtime) | Compatibility and relative priority (integration of the dashboard into existing workflows) | Time (≈) → climate (≈) The dashboard was seen as a priority; however, the staff did not have sufficient time to manage it on the same clinic day. The interviewee used downtime time from other clinic days to manage the intervention—relying on downtime (slack resources) did not have a significant influence on the implementation climate | Sustainment | “If VA’s prescribing it, we have to be responsible and do it the right way… because it’s part of our patient care, it’s supposed to be part of our clinic day, but again it’s not always feasible. So, I use the downtime that I have in my other clinic so I can go in and manage it” Site 38, Study ID 156 |