Table 1.

Agreed-Upon ERIC Implementation Strategies for Individual Barriers to Implementing the Cardiovascular Disease Risk Calculator

Barriers to Implementation
Subset of ERIC Implementation StrategiesAccess to Calculator1Workflow2Clinical ChampionTeam CommunicationTime3Calculator TrainingTrust in guidelines4Patient population5Patient Fears6Cost to Patients7Variations in Calculator Results8Buy-inStaffing9
Assess for readiness and identify barriers and facilitatorsCC
Develop a formal implementation blueprintIS&C
Conduct local needs assessmentCCC
Obtain and use patients/consumers and family feedbackIS&CIS&C
FacilitationISISISISISISISISIS
Provide local technical assistanceIS&CC
Tailor strategiesISC
Promote adaptabilityISISIS&C
Use data expertsISIS
Identify and prepare championsIS&CCCISISISIS&CIS
Organize clinician implementation team meetingsIS&CC
Recruit, designate, and train for leadershipIS
Inform local opinion leadersISISIS
Build a coalitionCIS
Identify early adoptersIS&CIS
Conduct local consensus discussionsISISCIS
Capture and share local knowledgeIS
Model and simulate changeISCIS
Visit other sitesISIS
Conduct ongoing trainingCIS
Provide ongoing consultationIS
Develop educational materialsISIS&CIS
Make training dynamicC
Distribute educational materialsISIS
Conduct educational meetingsIS&CCCCISC
Conduct educational outreach visitsIS
Shadow other expertsIS
Facilitate relay of clinical data to providersISIS
Revise professional rolesISIS&C
Involve patients/consumers and family membersISIS&CIS&C
Intervene with patients/consumers to enhance uptake and adherenceISIS
Prepare patients/consumers to be active participantsCISIS&C
Fund and contract for the clinical innovationC
Access new fundingISIS
Place innovation on fee for service lists/formulariesIS
Alter incentive/allowance structuresIS
Alter patient/consumer feesIS&C
Use other payment schemesIS
Change record systemsIS&C

  • Abbreviations: ERIC, Expert Recommendations for Implementing Change; C, ERIC strategies agreed upon by C only; IS&C, ERIC strategies agreed upon by both implementation scientists (IS) and clinicians (C); IS, ERIC strategies agreed upon by IS only.

  • 1 Accessibility to risk calculator/electronic health record integration.

  • 2 Documented workflow.

  • 3 Time constraints.

  • 4 Trust in guidelines (by clinicians).

  • 5 Patient population (i.e., perceived limited population at risk for cardiovascular disease).

  • 6 Patient fears (e.g., statin side effects).

  • 7 Patient issues with costs of medications.

  • 8 Results vary by calculator.

  • 9 Staffing issues.