Factors (Conditions), Condition Descriptors, and Qualitative Comparative Analysis Scoring (Calibration) Used to Identify Key Ingredients in Successful Registry Implementation
| Condition | Description of Condition | Calibration |
|---|---|---|
| Health system | The degree to which the practice was part of a large, multi-practice, hospital-owned health system | 1 = practice is owned by health system, complete control |
| 0 = practice is owned by the physicians or others in the practice | ||
| Key person | The degree to which there was a key person who “made things happen” for the registry implementation | 1 = very clear evidence of a key person; there, willing, and capable to do what was needed |
| 0 = no evidence of a key person or key persons; no one willing to step in and make things happen | ||
| QI mindset | The degree to which the practice displayed a mindset of interest in continually improving quality, looking for opportunity to change and get better | 1 = Past and ongoing QI mindset evident in multiple practice members; institutionalized or embedded in practice culture |
| 0 = No evidence of QI mindset, often evidence of contrary attitude (resisting change) | ||
| EHR capability | The extent to which the EHR had the capability to be changed to accommodate development of a registry; includes the extent to which the practice members or others in the system had the skills and knowledge to make these changes | 1 = EHR with registry features already included or completely able to make any changes needed; including consideration of the system capability and the organization allowing these changes |
| 0 = EHR not modifiable; cannot manipulate at all to meet reporting needs | ||
| Resources | The tangible items such as funding (to support people or EHR modifications), space, and time to complete necessary actions to get the registry to work | 1 = sufficient resources to “get the job done,” for example, training or dedicated time provided for on the ground key person to implement or maintain registry |
| 0 = lacking in resources such that a barrier or barriers were created, for example, no training provided when needed, or no time dedicated in already full workload for added tasks | ||
| Leadership | Usually at the health system level, but also at the practice level (if independent practice) to initiate and support changes for registry implementation | 1 = significant organizational leadership role in driving and supporting the change |
| 0 = no organizational leadership role in driving or supporting the change | ||
| Incentives | Anticipation of or actual availability of incentives for transformation, such as reimbursement changes or accreditation, as a motivator for PCMH transformation. | 1 = actual or potential for significant financial incentives as a driver of transformation |
| 0 = no incentives (in place or anticipated) as driver of transformation | ||
| OUTCOME: registry implementation “success” | Extent to which the practice was able to implement a fully functioning registry within their EHR within the time frame of the QI project | 1 = Completed full registry and had ability to report data as needed |
| 0 = Completely unable to implement registry or report needed data |