Table 2

Barriers to and Facilitators of Practice Implementation of APGAR Tools Captured by Staff Comments

MeasureStaff Comments
 Time“It takes time to try something new—we don’t have time.”
 Limited physician buy-in“Some physicians are just not willing to try anything new.”
 Limited nursing staff acceptance
 Lack of centralized mandate“Some of the nursing staff only do what is required by their physicians.”
 Unsure of need“Our patients are doing OK.”
 Feedback from patients“[With the Asthma APGAR tools] we actually knew what the patient was doing and thinking.”
 Asthma as quality target for practice
 Case reports“I got more information than I have ever had and…. it improved care.”
 Ease of use of tools
 Tools developed in primary care“Using the system definitely improved the asthma care and the patients liked it.”
  • APGAR = Activities, Persistent, triGGers, Asthma medications, Response to therapy.