Manage barriers and facilitators to implementation

Right Decision Service implementation guide
National

The table below summarises the evidence base on key barriers and facilitators to implementation of DSS.

 

Table 8: Barriers and facilitators to implementation of DSS.

Barriers

Facilitators

Lack of knowledge / awareness

 

Borum, 2018;
  • Utilise information dissemination techniques (see 4.3.2 above)
  • Utilise networks and facilitated interaction (see 4.3.2 above)
  • Skills and leadership development.

Olakotan 2020

Lack of training

 

Borum, 2018; Olakotan 2020
  •  Importance of a learning period / time for familiarisation of the technology
  • Provision of tailored learning opportunities.

Keyworth, 2018; Lee, 2020; Wu, 2012; Liu, 202; Van Dort, 2022; Thomas-Craig, 2021; Olakotan 2020

Service-level issues
  • Direct channels of communication between the developers responsible for creating the CDS service and the developers implementing the service
  • Need for adequate personnel beyond patient-facing clinicians alone
  • Importance of adhering to organizational preferences, achieving buy-in from health system leadership, and designating “on-the-ground” champions to facilitate adoption.

Wright 2015; Lee 2020

Barriers at system or patient levels

Eg. provider and patient beliefs, attitudes, and skills, professional interactions, clinical capacity and resources, and organizational support; external rules, regulations, and pressures

Kouri, 2022
  • Importance of implementation context and attaining good “clinician-patient-system integration”
  • Importance of further integrating implementation science principles into CDSS intervention design
  • Provide the appropriate safeguards for patient privacy.

Kouri, 2022