Barriers and Facilitators for Healthcare Providers Integrating Prevention into Connect Care EHR in Diverse Clinical Settings

Background: This study aims to understand healthcare providers and facilitators to implement screening, brief intervention and referral (SBIR) for modifiable risk factors (alcohol, tobacco and physical inactivity) using electronic health record (EHR) across acute and ambulatory care settings. Approach Alberta Health Services (AHS) is implementing SBIR for modifiable risk factors using EHRs across hospital settings. We employed a multiple case studies approach with co-design and qualitative descriptions to understand the experiences of diverse healthcare providers on SBIR implementation. Prior to SBIR implementation: Clinical leaders across AHS were engaged and consulted. Clinical sites were recruited to implement SBIR based on their readiness to implement SBIR. Implementation facilitators (IF) completed observational clinic inventories, engaged healthcare providers to understand workflow, capacity, patient context and load. Healthcare provider recruitment to implement SBIR is opportunistic and on-going at each clinical site. During SBIR implementation: We used participant observations, descriptive field notes, iterative semi-structured interviews with 6 IFs. Additionally, opportunistic touch-base calls, surveys, and interviews with healthcare providers are underway. Data collection is guided by the Consolidated Framework for Implementation Research (CFIR). Participant observations and touch-base calls are recorded as descriptive field notes. Three readiness surveys were conducted to ensure our team could rapidly facilitate support at each phase of healthcare provider implementation. Qualitative data were transcribed, abductive thematic analysis completed in NVivo 2/4 and mapped back to the CFIR to systematically understand barriers and facilitators. Findings are presented back to the team on a three-month cycle to ensure accurate interpretation and agile application of strategies to resolve barriers. Results: Preliminary results of providers SBIR implementation revealed barriers and facilitators are based on ...