PHYSICIAN BELIEFS |
AMDEs considered expected or unavoidable and not adverse unless outcomes catastrophic; viewed as more severe in other specialties |
Beliefs about consequences |
Social-professional role and identity |
Health professional cognitions: expected outcome |
Health professional cognitions: agreement with the recommendation |
Yes (expected outcome) |
AMDEs within 2 years of use were considered unusual |
Beliefs about consequences |
– |
Health professional cognitions: expected outcome |
Health professional cognitions: agreement with the recommendation |
Yes (expected outcome) |
Views about cause of AMDEs confounded by multiple factors |
– |
Beliefs about consequences, Knowledge |
– |
Health professional cognitions: agreement with the recommendation, Health professional knowledge and skills: domain knowledge |
Yes (knowledge) |
Incidence of AMDEs has decreased, thus devices were thought to be improved |
– |
Beliefs about consequences, optimism |
Health professional cognitions: expected outcome |
Health professional cognitions: agreement with the recommendation |
Yes (expected outcome) |
POLICIES, PROCESSES OR SYSTEMS |
Follow-up of device-related outcomes beyond short-term results done elsewhere |
Environmental context and resources |
Social-professional role and identity |
Recommended behaviour: observability |
Health professional cognitions: intention and motivation, Health professional behaviour: nature of the behaviour, Health professional knowledge and skills: knowledge about own practice, Health professional behaviour: self-monitoring or feedback, Professional interactions: referral processes |
Yes (professional role or behaviour, observability or knowledge of own behaviour) |
Devices implanted not recorded in patient records |
Environmental context and resources |
– |
Incentives and resources: information system |
Health professional knowledge and skills: knowledge about own practice, Health professional behaviour: self-monitoring or feedback, Health professional behaviour: capacity to plan change |
Yes (resources or information system) |
No hospital, national or international systems for AMDE reporting |
Environmental context and resources |
Knowledge, Reinforcement, Behavioural regulation |
Incentives and resources: information system, Incentives and resources: availability of necessary resources, Capacity for organizational change: regulations, rules and policies |
Health professional knowledge and skills: domain knowledge, Health professional cognitions: intention and motivation, Health professional behaviour: self-monitoring or feedback, Incentives and resources: non-financial incentives and disincentives, Incentives and resources: quality assurance and patient safety systems, Capacity for organizational change: monitoring and feedback |
Yes (resources or information system, knowledge, reinforcement or non-financial incentives or disincentives, regulation or self- or organizational monitoring) |
DEVICE MARKET |
Use of specific devices often determined by purchase group contract obligations |
Environmental context and resources |
– |
Health professional behaviour: capacity to plan change |
Capacity for organizational change: regulations, rules and policies, Incentives and resources: financial incentives and disincentives, Capacity for organizational change: mandate, authority and accountability, Social, political and legal factors: economic constraints on the health care budget, Social, political and legal factors: contracts |
Yes (context and resources or policies, financial incentives and disincentive, authority, budget, contracts) |
Lack of responsiveness to AMDEs from industry |
Reinforcement |
Knowledge, Optimism, Beliefs about consequences, Environmental context and resources |
– |
Health professional cognitions: expected outcome, Health professional cognitions: intention and motivation, Health professional behaviour: self-monitoring or feedback, Social, political and legal factors: influential people |
Yes (reinforcement or feedback or influential people, expected outcome, optimism or motivation) |