261 Discussion Table 1. (continued) 4. KLIK is of added value for the conversation with the clinician according to 58% of the patients and 59% of the parents. 5. KLIK is easy to use according to 81% of the patients and 74% of the parents 6. The majority of the patients (80%) and parents (74%) are satisfied with the PROMs they complete. Pediatric patients and parents were satisfied with the usability and effect of the KLIK PROM portal in clinical care. However, some points of improvements (i.e., irrelevant and long PROMs, no discussion of PROMs by clinician, suboptimal lay-out website) were also identified. 6 Assessment of the KLIK PROM portal implementation (a) To retrospectively describe the most prominent determinants of successful PROM implementation. (b)To identify current barriers of the KLIK PROM portal implementation. Not applicable A mixed-method design was used: (a) The CFIR framework was used to retrospectively describe the implementation process of the KLIK PROM portal and to identify determinants in this process. (b)The CFIR-ERIC Implementation Strategy Matching Tool was used to identify current barriers in the KLIK implementation and to match implementation strategies that address these barriers. (a) The strength of the KLIK PROM portal lies particularly in the following CFIR domains: intervention characteristics (e.g., easy to use, direct feedback), characteristics of individuals (e.g., motivated clinicians), and process of implementation (e.g., support KLIK expert team). (b)Barriers in the implementation lie mainly in the domain inner setting (e.g., involving/motivating all stakeholders) and intervention characteristics (e.g., complex to use for some clinicians, costs). The strategy ‘identify and prepare champions’ was identified as the most effective strategy in addressing the combination of identified barriers. CFIR provides clinicians and scientists guidance during a health care implementation process and can be used in all phases of implementation, although it is a quite extensive and complex framework with some overlapping constructs. 9
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