Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar 6:25:e41028.
doi: 10.2196/41028.

Determinants of Implementation of a Critical Care Registry in Asia: Lessons From a Qualitative Study

Timo Tolppa  1 , Vrindha Pari  2 , Christopher Pell  3   4 , Diptesh Aryal  5 , Madiha Hashmi  6 , Maryam Shamal Ghalib  7 , Issrah Jawad  1 , Swagata Tripathy  8 , Bharath Kumar Tirupakuzhi Vijayaraghavan  2   9   10 , Abi Beane  11 , Arjen M Dondorp  12 , Rashan Haniffa  11 ; Collaboration of Research Implementation & Training in Critical Care in Asia Investigators  13
Collaborators, Affiliations

Determinants of Implementation of a Critical Care Registry in Asia: Lessons From a Qualitative Study

Timo Tolppa et al. J Med Internet Res. .

Abstract

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.

Keywords: CCU; South Asia; critical care; health care; implementation; qualitative research; registry; stakeholders.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: AB has received a salary from Wellcome. RH has received grants from Wellcome, Canadian Institutes of Health Research, UK Research and Innovation/Medical Research Council and International COVID-19 Data Alliance. CP has received a part-time salary from the Wellcome Trust.

Figures

Figure 1
Figure 1
Organogram of the Collaboration for Research, Implementation, and Training in Critical Care in Asia team structure and stakeholders. The stakeholder groups invited to participate in the study are detailed in black.
Figure 2
Figure 2
Implementation of the Collaboration for Research, Implementation, and Training in Critical Care in Asia registry as reported by participants (dashed lines represent less frequent processes).
Figure 3
Figure 3
Topics, determinants, and themes of implementation.
See this image and copyright information in PMC

References

    1. Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, Adeyi O, Barker P, Daelmans B, Doubova SV, English M, García-Elorrio E, Guanais F, Gureje O, Hirschhorn LR, Jiang L, Kelley E, Lemango ET, Liljestrand J, Malata A, Marchant T, Matsoso MP, Meara JG, Mohanan M, Ndiaye Y, Norheim OF, Reddy KS, Rowe AK, Salomon JA, Thapa G, Twum-Danso NAY, Pate M. High-quality health systems in the sustainable development goals era: time for a revolution. Lancet Glob Health. 2018;6(11):e1196–e1252. doi: 10.1016/S2214-109X(18)30386-3. https://linkinghub.elsevier.com/retrieve/pii/S2214-109X(18)30386-3 S2214-109X(18)30386-3 - DOI - PMC - PubMed
    1. Platt JE, Raj M, Wienroth M. An analysis of the learning health system in its first decade in practice: scoping review. J Med Internet Res. 2020;22(3):e17026. doi: 10.2196/17026. https://www.jmir.org/2020/3/e17026/ v22i3e17026 - DOI - PMC - PubMed
    1. English M, Irimu G, Agweyu A, Gathara D, Oliwa J, Ayieko P, Were F, Paton C, Tunis S, Forrest CB. Building learning health systems to accelerate research and improve outcomes of clinical care in low- and middle-income countries. PLoS Med. 2016;13(4):e1001991. doi: 10.1371/journal.pmed.1001991. https://dx.plos.org/10.1371/journal.pmed.1001991 PMEDICINE-D-15-01349 - DOI - DOI - PMC - PubMed
    1. CRIT CARE ASIA Establishing a critical care network in Asia to improve care for critically ill patients in low- and middle-income countries. Crit Care. 2020;24(1):608. doi: 10.1186/s13054-020-03321-7. https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-03321-7 10.1186/s13054-020-03321-7 - DOI - DOI - PMC - PubMed
    1. Beck K, Beedle M, van Bennekum A, Cockburn A, Cunningham W, Fowler M, Grenning J, Highsmith J, Hunt A, Jeffries R, Kern J, Marick B, Martin RC, Mellor S, Schwaber K, Sutherland J, Thomas D. Manifesto for Agile Software Development. 2001. [2022-11-25]. https://agilemanifesto.org/

Publication types