Barriers and facilitators to implementing evidence based bleeding management in Australian Cardiac Surgery Units: a qualitative interview study analysed with the theoretical domains framework and COM-B model.

“In the public hospital system, a huge barrier is that doctors and medical people are not trained in the same way in business and in budgeting and even how to interact with groups outside the medical profession” (A) “The project management skills that you need to set up a program are quite significant, and I think many of us, not only don’t have the time to do it, but don’t have the skills unless you have them intrinsically, they are not there” (A) “You’ve got to learn how to talk to all these other people, the funders and the bean counters, you’ve got to learn to talk to them in a way that they understand and sell yourself” (A) Opportunity: physical opportunity, social opportunity ‘Opportunity’ (COM-B) can be explained as all the factors that lie beyond the individual, that make the management of bleeding or implementation of practice improvement, possible.

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