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Table 2 HIT debriefing for implementation using the Consolidated Framework for Implementation Research (CFIR) Framework

From: A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model

  Goal Debriefing outline CFIR domain [construct]
Act One Introduce HIT in the context of usual workflow Ensure shared mental model of septic patient Outer setting [Patient needs]
For patients at risk for deterioration, telehealth can help team observe the patient using the cart. What is the reality of the workflow at this point? Inner setting [Structural Characteristics, Implementation Climate]
Explore roles—who would set up the cart? Intervention [Complexity]
Have participants demonstrate physical maneuvers of cart Intervention [Complexity]Individuals [Knowledge and Beliefs]
Telehealth RN (in person) demonstrates activating cart—introduces responding eICU nurse Intervention [Complexity]Inner setting [Networks and Communications]
Learners demonstrate activating cart Intervention [Complexity]Individuals [Self-Efficacy]
Learners interact with telehealth nurse via cart Intervention [Complexity]
Act Two Identify anticipated barriers to
HIT use
Ensure shared mental model of severe sepsis Outer Setting [Patient Needs]
Explore ED context for using telehealth cart Inner Setting [Implementation Climate] Individuals [Knowledge and Beliefs]
Explore any prior experience with telemedicine HIT Intervention [Complexity]                                                              Individuals [Knowledge and Beliefs]
When would this be helpful? Inner Setting [Implementation Climate]                                          Individuals [Knowledge and Beliefs]
Intervention [Relative Advantage]
What would make it difficult? Intervention [Complexity]
Act Three Explore relevance, communication strategies and clinical pearls Ensure shared mental model of septic shock Outer Setting [Patient Needs]
Telehealth interactions: telephone vs video monitoring Intervention [Complexity]
Point-of-contact? (MD vs RN) Inner Setting [Networks and Communications] Intervention [Relative Advantage]
Communication strategies—in front of patient and/or families? Inner Setting [Culture]                                                                    Individual [Knowledge and Beliefs]
Conflicting views—how to address (TeamSTEPPS tools) Inner Setting [Culture]Individual [Knowledge and Beliefs]
The Sepsis Hospital Concept (eICU capabilities and limits) Intervention [Relative Advantage]
Wrap up: balancing barriers vs benefits Intervention [Relative Advantage, ComplexityProcess [Reflect and Evaluate]
  1. Lists goals, outlines descriptions, and corresponding CFIR domain for each debriefing ACT within the sepsis telehealth in situ simulation