Table 5 Overview of all reported facilitators and barriers of the RE-AIM Adoption dimension
CFIR domain | Facilitators | Barriers |
|---|---|---|
Intervention characteristics | • Professionals perceive a need and priority for additional support which makes them feel the need for collaboration (QA1.1)a • Provision of palliative care tools helps consultants concretize palliative care in intervention activities (QA1.2) • An intervention tailored to local collaborations and structures facilitates easy adoption of intervention (QA1.3) | • Benefit of consultations not recognized by all the professionals involved as not everyone feels the need to engage the consultant in bedside consultations (QA1.4) • Concerns about the relative advantage of the intervention as palliative care concerns a small population and narrow topic (QA1.5) |
Outer setting | • Pre-existing regular meetings in professionals’ network means that professionals who already have a network among other organizations can easily adopt the intervention (QA1.6) | • Unclear policies on responsibilities. due to too many external parties involved in care for homeless people. may hinder adoption of the intervention (QA1.7) |
Inner setting | • Intervention is compatible within existing workflow due to a clear route of palliative care (and responsibilities) within the organization participating in the intervention (QA1.8) • Shared vision on good healthcare among colleagues within the participating organization makes collaboration easier (QA1.9) • Shared views of involved professionals regarding equal and reciprocal cooperation (QA1.10) | • Norms and values within the organization for social service provision are often focused on social care, while somatic care gets less attention (QA1.11) • Limited skills in recognizing, discussing and providing palliative care within social services hinder adequate care at the end of life (QA1.12) • Many staff changes and insecure future prospects for organization make organizational commitment hard (QA1.13) • Limited support and engagement of management makes consultants feel they are getting little support (QA1.14) |
Characteristics of individuals | • Commitment and enthusiasm of the professionals involved regarding the intervention and palliative care (QA1.15) • Medical skills and knowledge of individual consultant makes professionals feel the consultant is competent (QA1.16) • An approachable consultant without their own agenda helps the professionals to adapt the intervention according to their needs (QA1.17) • Adoption is facilitated by consultants who proactively initiate consultations, organize training or participate in multidisciplinary meetings, which makes it easier for professionals to adapt to the involvement of the consultant (QA1.18) • A consultant who is familiar with the homeless population makes the intervention easier to adopt for social professionals (QA1.19) • Open mindset and attitude of professionals helps make them more motivated for palliative care (QA1.20) • Awareness of skill shortcomings makes individuals open to reflecting and learning (QA1.21) • Individuals who trust each other cooperate better in using the intervention (QA1.22) | • Low self-efficacy in palliative care skills may hinder identification of palliative care and use of the intervention (QA1.23) • Professionals’ differences in their views when a consultation is requested could hinder use of the intervention (QA1.24) |
Process |  | • Issues with converting the work plan and intentions into actions impedes planning and engaging appropriate individuals (QA1.25) • Unclear implementation route for intervention within organization (QA1.26) |