Estudios originales
Published on 24 de junio de 2026 | http://doi.org/10.5867/medwave.2026.05.3196
Exploratory study to identify facilitators and barriers for implementing a multiplatform communication app for prehospital screening and transfer follow-up in acute stroke
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Representative quotes for each facilitator and barrier identified, according to the normalization process theory.
| #1 | User-friendly and intuitive application | "It has helped us considerably and has been a very, very useful tool when all the stakeholders have finally managed to coordinate." [Participant 7]."It is a very intuitive application (...). It does not require extensive expertise at the beginning of its use, and because it is intuitive, the team can use it without any major difficulties." [Participant 8]. |
| #2 | Training and feedback | "The application support team was readily available, which was a facilitator (...). They were always willing to address concerns and make the necessary configurations." [Participant 6]."Training was provided continuously (...). There was never a time when the person in charge failed to respond to my emails (...). Honestly, it was excellent." [Participant 5]. |
| #3 | Leadership within the work team | "Our department head has consistently encouraged us to undergo training (...). Every time a stroke code is activated, she insists that we access the application (...). She has really been committed to it." [Participant 1]."There always has to be direction, someone who sets the course (...), a leader. That is how we operate." [Participant 4]. |
| #4 | Healthcare system workload | "There was a lack of motivation (...). They already have a heavy workload, and I think the fewer clicks and the less documentation they have to complete, the better." [Participant 3]."The truth is that they are extremely overloaded (...). About three weeks ago, I went to the emergency department to talk with colleagues about the application, and honestly, they were incredibly busy." [Participant 3]. |
| #5 | Resistance to change | "There was a lack of motivation (...). They already have a heavy workload, and I think the fewer clicks and the less documentation they have to complete, the better." [Participant 3]."There is no real culture of using applications, especially in the emergency department itself (...). The system is still very accustomed to relying on telephone calls." [Participant 6]. |
| #6 | Challenges in technology use and technical infrastructure | "The main difficulty has to do, as I mentioned earlier, with connectivity (...). Perhaps simply using a computer would have been easier." [Participant 7]."For younger people, it may be much easier, but for those of us who have been working with the same systems for years, it can be difficult to get people to come on board with something new." [Participant 7]. |
PNT, process normalization theory.
Source: Prepared by the authors.