Table 2 Determinants and exemplar quotes
Determinant | Exemplar quote |
|---|---|
Patient and clinician barriers | “I thought maybe they already knew the information on the paperwork because they’re supposed to connect through the internet which is like a circle. You know, your primary, your cancer, your research doctor, your breast cancer—all these people should be communicating” — Patient “They are getting refills from Oncology for diabetes or other, you know, chronic medical problems. Then they don’t feel the need to come to a PCP because they are getting medication refills done by Oncology. Then they will not feel the need to come over here” — Primary care provider |
Stakeholder engagement | “I think that some of these decisions are not local decisions – they are enterprise decisions. For example, it goes back to what panel of patients is appropriate for primary care physicians in order to allow them to better communicate, and what is the role of navigators in those settings? Because not necessarily everything has to be communicated through a physician to physician; some communications could be facilitated by a navigator. I think one part of it is that utilizing navigators is better for us, because our navigators can communicate effectively potentially with the primary care physician…So as we develop our navigation program, this can improve the communication between the clinics as well” — Administrator |
Organizational communication networks and characteristics | “Even if there’s no new information, [the nurse coordinator] could…join our meeting, have one slide, talk for two to five minutes and say ‘hey guys…this is who I am.’ Employees do better when they know the person, like seeing [the nurse coordinator], what does she look like, hearing her, making connections, improving engagement. So, then they are like, ‘oh yeah, this is what I do when my patient doesn’t have a PCP’” — Oncology provider |
Intervention characteristics | “The most important thing about [the nurse coordinator]…it was not just her knowledge, it was the fact that she is just a unique person. She was a go-getter. She always thought about ‘how can we do things better?’ She was very thorough” — Administrator |
Reflecting and evaluating over time | “I am sending her [a direct message via the EHR] and she is responding and saying, ‘yes, we can get it.’ It’s a huge help. So now our environment has changed from feeling completely unsupported to now actually having this backdoor to PCPs, which is a huge help” — Oncology provider |