Groups of barriers and facilitators independently associated with implementation and de-implementation
| Groups of barriers and facilitators | Implementation of medication guidelines OR (95% CI) | Implementation of referral guidelines OR (95% CI) | De-implementation of low value blood management practices OR (95% CI) |
|---|---|---|---|
| Innovation* | 1.83 (0.49 to 6.75) | 0.74 (0.38 to 1.42) | |
| Professional—outcome expectancy† | 2.73 (1.46 to 5.08)‡ | 1.56 (0.73 to 3.30) | 0.30 (0.13 to 0.71)‡ |
| Professional—motivation§ | 0.28 (0.11 to 0.70) ‡ | ||
| Patient¶ | |||
| Social context** | 1.22 (0.49 to 3.02) | ||
| Organisational context†† | 1.39 (0.84 to 2.30) | 2.54 (1.06 to 6.05)‡ | |
| Economic and political context‡‡ | 0.43 (0.19 to 0.98)‡ | ||
*Innovation: characteristics of the practice to be implemented or de-implemented, for example, attractiveness.
†Professional—outcome expectancy: the perceived net benefit of the practice to be implemented or de-implemented to patients by the orthopaedic surgeons. ‡p<0.05, factors significantly associated in multivariate analyses (independent associations).
§Professional—motivation: motivational factors for orthopaedic surgeons to implement or de-implement the practice in question, for example, own or department priorities.
¶Patient: patient-related factors, for example, patient pressure, comorbidities.
**Social context: factors related to the social context of the professional, for example, opinion of colleagues, leadership.
††Organisational context: factors related to the organisation of care processes, for example, staff capacities, structures.
‡‡Economic and political context: factors related to economic and political context, for example, financial arrangements, regulations and policies.