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Table 1 (abstract P41). Example CFIR construct, barriers, solutions, and outcome (adapted from Stark et al1)

From: Proceedings from the 2nd Annual UK Implementation Science Research Conference, 'Advancing the science of scaling up: Improving efficiency and effectiveness of implementation strategies in healthcare': meeting abstracts

CFIR construct Barrier Enabler identified Outcome
Networks & Communications Delay in referral to clinical genetics Clearly communicate availability of rapid genomic testing and indications for referral Earlier referrals to clinical genetics
Relative advantage Ensure referrers get feedback on diagnostic and clinical impact of rapid genomic testing, e.g. at monthly NICU/Genetics case review meetings Increased number of referrals to clinical genetics
Implementation climate Parental difficulty processing complex information in a stressful environment Increased genetic counselling support in the acute setting Higher rate of rapid genomic testing acceptance by families
Adaptability Results batched ready for weekly dedicated MDT meeting Initiate multidisciplinary team meetings for single cases, with minimum quorum defined Reduction in time to report
Formal implementation leaders Absence of an established
rapid genomic testing pathway
Clinical and laboratory champions identified Formal rapid genomic testing operating procedure
established
  1. Interviews for the multi-state trial are ongoing. Early findings indicate the importance of relationships between genetic and paediatric intensivist staff