Table 2.

Impact of the KCCQ-12 Implementation Components on Physician Engagement

Aspect of KCCQ-12 Implementation		Exemplar Quotes
Clinician Engagement	Engaged Implementation Champion (Facilitator)	“He wanted to meet up with the APPs and the providers individually, or in a group setting to kind of break it down in the pre-rollout process. So I think that was very critical because we had some time, maybe even over a month to just prepare and understand. And then I think while it was rolling out, rolled out I think he did provide emails with refreshers, ‘By the way in case everyone forgot this is the presentation I made, if anyone needed some reference or resource.’” (Clinician 3)
	Clinic Staff Education and Training (Proposed Solutions)	“I think, for me, it [the education] was fine. I think for the rest of my clinic team, I think they probably needed a little bit more background, like why this is useful. … where they understand the background behind … the utility of it. And then understanding how it can help them.” (Clinician 2)
KCCQ-12 Trialability	Straightforward usage and interpretation of the KCCQ-12 (Facilitator)	“It’s a very straightforward questionnaire.” (Clinician 2)
KCCQ-12 Design	Important insight gained from the KCCQ-12 (Facilitator)	“I found that the end questions, when it does talk about quality of life, specifically that question about, ‘If you had to live with your heart failure like this for the rest of your life, how would you feel?’ I find that question particularly enlightening. And I think it’s sometimes hard to ask those questions just organically. That doesn’t really fit into conversation very well. So I think using the scale allows you to have just an opportunity to ask that question that it wouldn’t flow naturally. So we when tell people we’re doing the questionnaire, we say this is just so that we can note how you’re doing now and then how you’re doing three months later. A lot of the questions are familiar to them, but some of those questions I feel about the quality of life are particularly impactful because you get a sense of it just based on what they’re doing, their activity, their demeanor, but you don’t really get the full like, ‘How do you feel from your point of view?’ blunt question answer about the quality of life stuff. So I think it is useful.” (Clinician 13)
	Patient Interpretation of the KCCQ-12 (Barrier)	“I think there’s such a complicated interaction between the patien’ts personality and how they interpret those forms.” (Clinician 11)
KCCQ-12 Integration into Clinic Workflow	Time-consuming and new addition to workflow (Barrier)	“I did initially find it time-consuming compared to what the other tools that we have, but now, when I look at it, I don’t think i’ts time-consuming because the information we gather from it is valuable.” (Clinician 16)
	Automation in EHR notes (Proposed solutions)	“Honestly, I would love to see it with my vital signs.” (Clinician 12)

KCCQ-Kansas City Cardiomyopathy Questionnaire 12, APP-Advanced Practice Providers, EHR-Eletronic Health Record