162 Chapter 6 Table 1. (continued) CFIR domain CFIR determinants Reasons for successful implementation Characteristics of individuals Knowledge & Beliefs about the intervention • Multidisciplinary teams initiate implementation themselves and are, therefore, motivated to use KLIK. However, some clinicians of a team may have a negative attitude and show resistance, because they do not know the added value of using PROMs in clinical practice. The KLIK training provides knowledge of underlying principles and helps to generate enthusiasm • Research shows that clinicians are more satisfied about their provided care when using PROMs [35] and that the majority of clinicians experience personal benefit from using KLIK, e.g., by helping them in communicating with patients/parents [36] Characteristics of individuals Self-efficacy • The KLIK training provides clinicians with knowledge, tools, and skills to feel competent to implement KLIK in their practice. However, there could even be more emphasis on training communication skills, as some clinicians report low confidence in discussing psychosocial topics with their patients • Research shows that most clinicians have sufficient knowledge to use KLIK as intended [29] • Current focus is on empowering patients to discuss PROMs with their clinician, for example by developing educational videos Process of implementation Planning • The steps necessary to implement KLIK are clearly defined (see Figure 2) and adapted to the specific situation of each multidisciplinary team. • The KLIK expert team supports this process. Process of implementation Reflecting & Evaluating • During the annual evaluation meetings, the team members are provided with feedback regarding response rates and progress, in order to improve implementation outcomes [35]. • Patient panels are consulted about their needs/preferences with regard to the implementation process.
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