Table 4.
CFIR constructs not associated with PVS performance
| CFIR Constructs | PVS Cases | ||
|---|---|---|---|
| A | B | C | |
| Intervention characteristics | |||
| Relative advantage | It is really a great project. For a patient’s own doctor, to guide their eating patterns and to encourage a healthy diet to combat their cholesterol; for my doctor, to tell me that I need to eat broccoli to prevent colon cancer, that’s fantastic. It is great if a professional facilitates that conversation. (+1) | I am happy about this. About how to work? Obviously, it has made my clinical work better, that’s clear. (+1) | Our profession is going in this direction and with all the chronic patients. To have expanded the work to the whole healthy population has been very important; it raises the profile of these three healthy habits. (+1) |
| Complexity | We have to attend all chronic patients, the ones we have had for a long time. We have that plus the home visits. (−2) | If this is a new task at work, if we have to do it and not abandon any of the other present tasks, it is just an additional task; another story is if the task can be accomplished or not, that’s something else. (−1) | If we don't one thing, we can do another. (−2) |
| Outer setting | |||
| Patient needs & resources | The patient’s schedule, and then the patients tell you that they will do it, that they know how to eat well, or that they know how to exercise, or that they know about quitting tobacco, then they will do it when they can (…). Then you are left with the question: What do I do with this patient? (−1) | It is really hard, seeing the economic conditions that many of our patients are facing. If they are a homemaker and go to the grocery store and have spent a bunch of money on fruits and vegetables, to ask if they are eating their oranges (all nod and laugh), well, how can you say that to her, for many, there is not enough money. (+1) | I think people get scared, scared of being told off. (−1) |
| External policy & incentives | To be attentive to the project as well as the electronic prescription, and your own clinical work, it is exhausting. (−2) | The information technology depends on others and it is very slow when you want to make changes. (−1) | I don't know if you have the same impressions from other centers involved but the PVS is an additional task that we have compared to other centers because everything is an imposition from senior management. (−2) |
| Inner setting | |||
| Structural characteristics | They are not short of work, nor her or any of the nurses in this center. To be able to make this program work, we need more nursing resources. (−2) | I doubt it; with limited resources we cannot make it all work, because there are so many other tasks that need to be accomplished. (−2) | The larger centers have a real difficulty in adapting to structural changes. (−2) |
| Readiness for implementation: Available resources | You bring here a scanner that doesn't work, that doesn't read correctly. Then it doesn't serve any purpose. (−2) | Barrier you say? For us, the time that is required. (−1) | We are just a physician and a nurse, so the assessment requires a tremendous effort. (−1) |
| Process | |||
| Engaging: Formally appointed internal implementation leaders | The coordinator who runs this motivates us; she is all over us so that we achieve the goal. (+2) | She is really motivated. She is more involved with this and she is much more motivated. (+2) | A responsible peer has been helping me, many times; he has invested his own time and also mine so that I could learn in a more effective way. (0) |