Table 2 Patient pathway with mapped barriers and domains
Patient pathway | Barrier identified | Domain |
|---|---|---|
Patient presents at hospital | Potential long wait time in Accident and Emergency | Environmental context and resources |
Patient shows clinical features that indicate a lumbar puncture is required | Relies on clinical feature recognition | Knowledge |
Memory | ||
Beliefs about consequences | ||
Decision is made to perform a lumbar puncture | May require several people to make this decision | Professional role |
Emotion | ||
Social influences | ||
Patient is admitted to ward/medical admissions unit for a lumbar puncture to be performed | Patient will need to be re-clerked | Beliefs about consequences |
Environmental resources and context | ||
Staff allocated to perform a lumbar puncture
| Shift pattern, other duties, perceived importance of a lumbar puncture | Beliefs about capabilities |
Beliefs about consequences | ||
Emotion | ||
Equipment and supervision found: Lumbar puncture ready to go ahead | Need to know what equipment is needed, where it is and finding someone to supervise | Knowledge |
Memory | ||
Lumbar puncture performed | Many external factors as well as skill | Skills |
Beliefs about capabilities | ||
Emotion | ||
Results available. Management plan made | Who can make the plan, delays with results and knowledge to interpret | Professional role |
Beliefs about consequences | ||
Social influences | ||
Additional test needed | Who can action this? Further delays can occur here | Beliefs about social comparison |
Consequences | ||
Knowledge |
