Table 4

CQ 3: Contextual Factors That Appear to Hinder the Success of the Intervention Strategies

ContextKey Barriers
Organizational
  • Time (16,17,30,47–51)

  • Human resources (48,49)

Clinician Knowledge, Attitudes, and Beliefs
  • Skepticism—concern about evidence base of guidelines, lack of universal acceptance of recommendations, implied rationing of services, fear of litigation (24,47,49–51)

  • Lack of knowledge of guidelines (24,32,49,50)

  • Age—older or more experienced clinicians less inclined to use (48)

Workflow and TimingTiming and effectiveness—barrier to effectiveness if further away from point of decision making (42,52–55)

CQ indicates clinical question.