Table 3.

Most Reported Barriers by Clinicians, Nurses, and Other Health Professionals Involved in MAHVI’s Routine Depression Screening Protocol.

	Theme	Examples of Comments
1	Competing priorities especially in an era of short length of stay	“Too many things to pay attention to” [resident] “Last on the priority list” [nurse] “Fighting against time” [social worker]
2	Protocol logistics/process issues/multiple steps	“Order sets not always on chart” [resident] “Sometimes sticker is missed” [nurse practitioner] “Multiple steps make it difficult” [nurse]
3	Concerned about patients’ reactions/resistance about screening/consult	“Older people get upset” [nurse] “Patients are overwhelmed already” [nurse] “I sometimes re-phrase” [nurse]
4	Feel not responsible/lack of ownership about process	“Wonder if we are stepping on toes of primary care physicians” [cardiologist] “I consider the sticker to be documentation” [cardiologist] “The more the process is taken out of my hands, the better and faster the patient will get the appropriate care” [cardiologist]
5	Education and feedback about protocol	“More follow education and feedback to the staff is needed” [cardiologist] “Vaguely remember initial education” [resident] “Some nurses are not aware of the protocol” [nurse]