Table 2.

Key CFIR Constructs and Illustrative Quotes

Domain	Construct	Interview Quote (s)	Key Lessons Learned
Inner Setting	Networks & Communication	“It took weeks to wait on approval for the letters. It ended up impacting the perception of hiding information.” –Facility Director	Existing networks and communications patterns, positive or negative, will impact the ability to organize and disclosure in a timely way.
	Culture	“I think as far as what, clinically how we moved forward, I think a lot of, um, what I’ve done next in my team is t-to remind people to s-, ya know, speak up if you see something that doesn’t seem quite right.” –Facility Director	Establish supportive culture focusing on open communication and importance of transparency prior to implementation.
Intervention Characteristics	Design of Notification & Packaging	“I liked getting the phone call because it kept me from being shocked, like shocked about getting AIDS or something. They reassured me, they said just come down and we’ll check it out.” –Patient	Patients prefer phone call first.
	Execution	“I think we shoulda been told (the testing results) a lot sooner that, that’s my only still, it’s not a complaint or a blame game.” –Patient	Minimize layers of approval and time delays to move quickly.
Process	Engaging External Stakeholders	“I would have involved stakeholders earlier. Give them a heads up. You might not have all the answers but you can say to them, this is what we know so far and we’ll follow through. Give them lots of updates.” –Facility Leadership	Involve stakeholders as early as possible and maintain communication throughout.
	Reflecting & Evaluating	“We’ve just bashed our head against the wall so many times with this and it’s just silly that, you know, we, that there isn’t a central clearing house of information - a set of, you know, recommendations everyone can follow.” -Facility employee	Hold formal evaluations and sharing of lessons learned within the organization following a large-scale disclosure.