Table 1.

Critical success factors in the CVC program innovation context.

Factors related to IT innovations failure in the literature	Experience of the CVC program innovation and critical success factors
Organizational culture (e.g., the environmental context of a healthcare organization, such as those that emphasize the need for continual improvement) (6, 8)	The UOHI aims to continually improve the care provided for cardiac patients. The organizational culture at the hospital creates an environment that emphasizes the importance of innovation and providing better care. Patient and family engagement is part of the engagement culture at the UOHI with patients or their caregiver serving on project teams and committees and contributing to the optimal decisions on innovations.
Structural factors (e.g., organizational characteristics, availability of resources, etc.) (6, 8)	Research and innovation funding was used to start the CVC program. Additional funding from the UOHI operating budget was also utilized to support the CVC program. Permanent funding through the MOHLTC was also secured for the program. In addition, given the large size of UOHI, the organization was better positioned to support the CVC program (e.g., more human resources, expertise available, etc.).
Technical challenges (e.g., lack of interoperability, limitations in the technical features of the IT solution, inability to adapt the systems to the needs of the user) (4, 9, 16)	The UOHI worked alongside a technology vendor (THM and IVR) to ensure that the features of the IT solution met the needs of the users (e.g., patients, nurses, etc.). Coordination and communication with the vendor was critical to ensure that technical challenges faced by staff members were addressed in a timely manner.
Capacity to support the IT solution (e.g., staffing) (4, 9)	Using the initial CVC program funding, and subsequent MOHLTC funding following the positive evaluation results, the UOHI was able to staff nurses to support the CVC program.
High levels of inertia (e.g., healthcare professional's resistance to change) (8)	The CVC program is “nurse-run” and involved the users from the initial project development. The users had ownership of the program, and were involved in various stages of the decision-making, including the selection of the initial technologies.
Limited Staff buy-in (e.g., due to changes in administrative and clinical workflows when implementing IT solutions) (7, 12, 41, 42)	While the IT solutions within the CVC program did require changes to staff members’ administrative and clinical workflow, there was high buy-in in the CVC program as staff perceived that the program, through its e-health applications, allowed them to remain connected with their patients and do their jobs more efficiently (e.g., seeing additional patients in a workday).