Table 3.

Qualitative interview guide domains with example items

Domains	Primary and Secondary Items
Role in the facility related to elective PCI:
General role	What is your title and function at your facility?
Specific clinical role	Are you presently practicing in the cath lab?
Description of the process/steps from referral through scheduling of a patient for an elective coronary procedure:
Referral process	Please describe the process of how patients are referred for a coronary procedure?
	What do you think is important to do prior to the cath lab to help ensure the necessity of the coronary procedure?
	How do you obtain this data/medical records?
	What is your opinion of the current process for patient referral for elective coronary angiography and PCI?
	Are there differences in how patients are referred from providers outside of the center?
	Are referrals for coronary procedures reviewed prior to scheduling?
	Does the cath lab contact the patient after the referral but before the procedure has been scheduled?
Challenges in the referral process	Can you think of practical issues or pressures that make it challenging to ensure a patient is ready for a coronary procedure?
	Are there pressures to accept referrals for coronary procedures?  • Probe to describe details
History of referral process	Please tell us how these referral processes were developed?
	If a change in the referral process has occurred in the past few years: can you tell me what the impact has been?
Description of the processes involved after a patient has been scheduled for an elective coronary angiogram or PCI:
Challenges	Can a scheduled coronary procedure be cancelled prior to a patients’ arrival at the facility?  • Probe to describe details
General questions about cath lab:
Contextual factors	Please describe the working environment, the culture, in your cath lab?
	Please tell us about the involvement hospital administrators, such as quality officers and financial officers, have in patient referrals for elective coronary procedures?