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Table 3 Exogenous factors that promote or inhibit the implementation of DSTs

From: Arduous implementation: Does the Normalisation Process Model explain why it's so difficult to embed decision support technologies for patients in routine clinical practice

User groups Physicians Patients Managers
Skill-set workability ▪ Delegating to autonomous patients ▪ Skills for participation ▪ Specification of roles and competencies
  ▪ Communicating clinical decisions and risks ▪ Accepting delegated clinical decisions ▪ Definition of standard operating procedures and job descriptions.
  ▪ Identifying appropriate professional roles for DST delivery ▪ Gaining competence ▪ Defining decisions to meet organizational goals
  ▪ Delegating to other professionals   
  ▪ Identifying and evaluating competencies   
  ▪ Defining boundaries between determinate and indeterminate decision-making   
Contextual Integration ▪ Allocating physical media   ▪ Managing allocation decisions
  ▪ Allocating time   ▪ Organizing protocols
  ▪ Appraising value   ▪ Controlling budgets
  ▪ Negotiating with managers   ▪ Managing professional autonomy
  ▪ Managing medico-legal concerns.   ▪ Managing patient choice