ArticleImplementation science : IS2010
Implementing quality indicators in intensive care units: exploring barriers to and facilitators of behaviour change.
Article in Implementation science : IS, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2026Pooled it
- Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level measures.Implementation science : IS · 2013Pooled it
- A multifaceted feedback strategy alone does not improve the adherence to organizational guideline-based standards: a cluster randomized trial in intensive care.Implementation science : IS · 2015Trial
- Evaluating the effectiveness of a tailored multifaceted performance feedback intervention to improve the quality of care: protocol for a cluster randomized trial in intensive care.Implementation science : IS · 2011Trial
- Contextual determinants of implementation of stakeholder-selected quality indicators in Indian intensive care units: a mixed-methods evaluation within a national registry network.Frontiers in health services · 2026Article
- The POETIC (PrOcess Evaluation of Trials In Critical care) Framework: A Structured Approach for Designing and Conducting Process Evaluations in Critical Care Trials.Critical care explorations · 2025Article
- Development of consensus quality indicators for cancer supportive care: a Delphi study and pilot testing.BMC health services research · 2024Article
- Evaluation of ICUs and weight of quality control indicators: an exploratory study based on Chinese ICU quality data from 2015 to 2020.Frontiers of medicine · 2023Article
- Mobilizing registry data for quality improvement: A convergent mixed-methods analysis and application to spinal cord injury.Frontiers in rehabilitation sciences · 2023Article
- The Impact of Patient-Centered Care on Cancer Patients' QOC, Self-Efficacy, and Trust Towards Doctors: Analysis of a National Survey.Journal of patient experience · 2023Article
- Article
- How does nursing-sensitive indicator feedback with nursing or interprofessional teams work and shape nursing performance improvement systems? A rapid realist review.Systematic reviews · 2022Review
- Prospective multicentre multifaceted before-after implementation study of ICU delirium guidelines: a process evaluation.BMJ open quality · 2020Article
- Tailoring an educational program on the AHRQ Patient Safety Indicators to meet stakeholder needs: lessons learned in the VA.BMC health services research · 2018Article
- An Appraisal of Mortality in Intensive Care Unit of a Level III Military Hospital of Bangladesh.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2017Article
- Barriers and carriers: a multicenter survey of nurses' barriers and facilitators to monitoring of nurse-sensitive outcomes in intensive care units.Nursing open · 2017Article
- Occupational physicians' perceived barriers and suggested solutions to improve adherence to a guideline on mental health problems: analysis of a peer group training.BMC health services research · 2016Article
- Poor adherence to guidelines for preventing central line-associated bloodstream infections (CLABSI): results of a worldwide survey.Antimicrobial resistance and infection control · 2016Article
- Theoretical domains framework to assess barriers to change for planning health care quality interventions: a systematic literature review.Journal of multidisciplinary healthcare · 2016Review
- How to implement quality indicators successfully in palliative care services: perceptions of team members about facilitators of and barriers to implementation.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2015Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelled
backgroundQuality indicators are increasingly used in healthcare but there are various barriers hindering their routine use. To promote the use of quality indicators, an exploration of the barriers to and facilitating factors for their implementation among healthcare professionals and managers of intensive care units (ICUs) is advocated.
methodsAll intensivists, ICU nurses, and managers (n = 142) working at 54 Dutch ICUs who participated in training sessions to support future implementation of quality indicators completed a questionnaire on perceived barriers and facilitators. Three types of barriers related to knowledge, attitude, and behaviour were assessed using a five-point Likert scale (1 = strongly disagree to 5 = strongly agree).
resultsBehaviour-related barriers such as time constraints were most prominent (Mean Score, MS = 3.21), followed by barriers related to knowledge and attitude (MS = 3.62; MS = 4.12, respectively). Type of profession, age, and type of hospital were related to knowledge and behaviour. The facilitating factor perceived as most important by intensivists was administrative support (MS = 4.3; p = 0.02); for nurses, it was education (MS = 4.0; p = 0.01), and for managers, it was receiving feedback (MS = 4.5; p = 0.001).
conclusionsOur results demonstrate that healthcare professionals and managers are familiar with using quality indicators to improve care, and that they have positive attitudes towards the implementation of quality indicators. Despite these facts, it is necessary to lower the barriers related to behavioural factors. In addition, as the barriers and facilitating factors differ among professions, age groups, and settings, tailored strategies are needed to implement quality indicators in daily practice.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.