Table 2.

Most common facilitators and barriers for sites A and B

  • Broader community health influences (eg, outbreaks of illnesses)

  • Communication (connecting with providers outside the practice)

  • Community resources related to intervention—facilitators during the planning and sustainability phases*

  • Educational and networking resources related to IDOCC

  • Macro-level economic and political environment (eg, financial resources from government)

  • Change in practice model (eg, to a different type of primary care model)

  • IT and EMR (experiences or beliefs about IT and EMR)—barrier during implementation*

  • Leadership

  • Micro-level financial resources (within the organization)

  • Office efficiency (organization and management)—barrier and facilitator during planning and implementation*

  • Space (characteristics of location or work and office areas)

  • Staff mix (availability and involvement of staff)

  • Time (time available)

  • Communication between and among staff

  • Personal and staff functioning as part of a team

  • Provider attitude toward the IDOCC intervention—barrier during implementation and sustainability phases*

  • Roles and responsibilities (clarity and scope of practice)—barrier during planning*

  • Awareness and insight of practice about processes needing adjusting

  • Charting, flow sheets, and template (attitude and experience)—facilitator during implementation*

  • Comprehending, complying, and agreeing with recommendations from IDOCC audit

  • Patient-physician processes (attitude and experience toward these, such as self-management)

  • PF’s capacity to spread learning from another innovation to the site—facilitator during implementation*

  • Reaction of practice to PF’s involvement and advice—facilitator during implementation*

  • Reminder system (attitude and experience)

  • Very few patient-level barriers and no patient-level facilitators were identified

  • EMR—electronic medical record, IDOCC—Improved Delivery of Cardiovascular Care, IT—information technology, PF—practice facilitator.

  • * The most common facilitators and barriers identified in ≥ 25% of a given subtheme for either case, noted by program phase.