TY - JOUR
T1 - Determinants of Implementation of a Critical Care Registry in Asia
T2 - Lessons From a Qualitative Study
AU - Tolppa, Timo
AU - Pari, Vrindha
AU - Pell, Christopher
AU - Aryal, Diptesh
AU - Hashmi, Madiha
AU - Shamal Ghalib, Maryam
AU - Jawad, Issrah
AU - Tripathy, Swagata
AU - Tirupakuzhi Vijayaraghavan, Bharath Kumar
AU - Beane, Abi
AU - Collaboration of Research Implementation & Training in Critical Care in Asia Investigators
AU - Dondorp, Arjen M.
AU - Haniffa, Rashan
N1 - Funding Information:
This study was funded by the Wellcome Innovations Flagship Program Award (grant 215522/Z/19/Z). The study sponsor had no role in study design, conduct, data interpretation, report writing, or the decision to submit for publication. We would like to give thanks to all of our participants, who volunteered their time to take part in this study, and all stakeholders in the Collaboration of Research Implementation and Training in Critical Care in Asia, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand (CCA) for their ongoing collaboration, including the named investigators below. Please note that individual affiliations can be found in Multimedia Appendix 1.
Funding Information:
AB, AMD, RH, IJ, and TT conceptualized the study. AB, RH, IJ, VP, CP, and TT developed the methodology. VP and TT verified the overall reproducibility of the results, and conducted management activities to annotate, scrub and maintain research data. AB, VP, CP, and TT applied formal techniques to analyze study data. IJ, VP, CP, and TT conducted the research and investigation processes. AB and RH provided the study resources, and took managerial responsibility for the research activity planning and execution. TT wrote the initial draft and created the visualizations for the work. DA, AB, AMD, RH, MH, MSG, ST, and BKTV provided supervisory oversight for the research activity planning and execution. AB, AMD, and RH acquired the financial support for the study. All authors critically revised the manuscript. All authors had full access to all the data in the study and took final responsibility for the decision to submit it for publication. VP and TT accessed and verified the underlying data and took responsibility for the integrity of the data and the accuracy of the data analysis.
Funding Information:
Each country in the network adapts the CCA registry to their priorities and manages it as their own national registry with financial support from the CCA. The Pakistan Registry of Intensive CarE (PRICE) commenced in August 2017 and now includes 70 units [6]. The Indian Registry of IntenSive Care (IRIS) was established in January 2019 and has 34 contributing units [7]. The Nepal Intensive Care Registry Foundation (NICRF) started in September 2019 and currently includes 14 units. The critical care registry was initiated in Afghanistan in August 2020 and, at present, covers 20 units. The characteristics of the included sites and registries are outlined in Multimedia Appendix 1.
Publisher Copyright:
© 2023 Journal of Medical Internet Research. All rights reserved.
PY - 2023/3/6
Y1 - 2023/3/6
N2 - BACKGROUND: The Collaboration for Research, Implementation, and Training in Critical Care in Asia (CCA) is implementing a critical care registry to capture real-time data to facilitate service evaluation, quality improvement, and clinical studies. OBJECTIVE: The purpose of this study is to examine stakeholder perspectives on the determinants of implementation of the registry by examining the processes of diffusion, dissemination, and sustainability. METHODS: This study is a qualitative phenomenological inquiry using semistructured interviews with stakeholders involved in registry design, implementation, and use in 4 South Asian countries. The conceptual model of diffusion, dissemination, and sustainability of innovations in health service delivery guided interviews and analysis. Interviews were coded using the Rapid Identification of Themes from Audio recordings procedure and were analyzed based on the constant comparison approach. RESULTS: A total of 32 stakeholders were interviewed. Analysis of stakeholder accounts identified 3 key themes: innovation-system fit; influence of champions; and access to resources and expertise. Determinants of implementation included data sharing, research experience, system resilience, communication and networks, and relative advantage and adaptability. CONCLUSIONS: The implementation of the registry has been possible due to efforts to increase the innovation-system fit, influence of motivated champions, and the support offered by access to resources and expertise. The reliance on individuals and the priorities of other health care actors pose a risk to sustainability.
AB - BACKGROUND: The Collaboration for Research, Implementation, and Training in Critical Care in Asia (CCA) is implementing a critical care registry to capture real-time data to facilitate service evaluation, quality improvement, and clinical studies. OBJECTIVE: The purpose of this study is to examine stakeholder perspectives on the determinants of implementation of the registry by examining the processes of diffusion, dissemination, and sustainability. METHODS: This study is a qualitative phenomenological inquiry using semistructured interviews with stakeholders involved in registry design, implementation, and use in 4 South Asian countries. The conceptual model of diffusion, dissemination, and sustainability of innovations in health service delivery guided interviews and analysis. Interviews were coded using the Rapid Identification of Themes from Audio recordings procedure and were analyzed based on the constant comparison approach. RESULTS: A total of 32 stakeholders were interviewed. Analysis of stakeholder accounts identified 3 key themes: innovation-system fit; influence of champions; and access to resources and expertise. Determinants of implementation included data sharing, research experience, system resilience, communication and networks, and relative advantage and adaptability. CONCLUSIONS: The implementation of the registry has been possible due to efforts to increase the innovation-system fit, influence of motivated champions, and the support offered by access to resources and expertise. The reliance on individuals and the priorities of other health care actors pose a risk to sustainability.
KW - CCU
KW - South Asia
KW - critical care
KW - health care
KW - implementation
KW - qualitative research
KW - registry
KW - stakeholders
UR - https://www.scopus.com/pages/publications/85150000416
U2 - 10.2196/41028
DO - 10.2196/41028
M3 - Article
C2 - 36877557
SN - 1438-8871
VL - 25
SP - e41028
JO - Journal of medical Internet research
JF - Journal of medical Internet research
M1 - e41028
ER -
SDG 9 Industry, Innovation, and Infrastructure