Skip to main content

Table 3 Respondent feedback on experience with using the SAT

From: Leveraging quality improvement through use of the Systems Assessment Tool in Indigenous primary health care services: a mixed methods study

Theme

Representative respondent comments

Benefit to health centre from using SAT

[The SAT allowed the centre to] “reflect on systems and system utilisation, identify differences between programs in system utilisation, and to identify barriers/issues in systems. (respondent02)

“Many clinic managers conveyed that they felt more in control of all the various challenges and could see the linkages and a map to help move forward.” [respondent11)

[The SAT] “supported clinic staff to discuss challenges within a safe space with management [to] help guide immediate/future planning.” (respondent11)

“Focussed, directed planning time.” (respondent13)

“Reflect on clinical practices – measure gaps and achievements; reflect on processes, documentation and services delivery.” (respondent14)

“Facilitated group discussion and decision-making; enabled staff to identify the things that they were doing well.” (respondent15)

Benefit to team from using SAT

“Team together, and talking.” (respondent06)

“Great opportunity for team building.” (respondent07)

“Developing, expressing ideas. Coming together as a team – much needed – brilliant.” (respondent08)

“Team building.” (respondent10)

“Shared understanding of role within the service. Focused, directed planning time.” (respondent13)

“Audit process and SAT was a very valuable experience for the whole team. All staff enjoyed and benefited from auditing/audit results and SAT – identifying issues and gaps and then planning to improve our service by adapting.” (respondent14)

Different applications of SAT in health centres

[The regional service has always] “done interpretation, feedback, the SAT, and goal setting in one session.” (respondent13)

Changes in health centres resulting from conduct of SAT

“Recommended the manager identify under-utilisation in services, and incorporate this in the Action Plan.” (respondent02)

“Placed prompts in prominent places.” (respondent04)

“Team became cohesive, with changes in staff/time.” (respondent08)

“Change in role of health promotion in organisation. Increased forms of health promotion in the organisation and this happened by the appointment of a new staff member.” (respondent10)

“Tried to police what was really affecting them. Most wanted more staff – couldn’t address.” (respondent12)

[Addressed] “documentation” (respondent14)

“Especially when they ran the SAT two times – improved processes. They went through a time of change and their results picked up.” (respondent16)

“The information that is gathered in the SAT was used as evidence to make recommendations for improvements in the PHC system. Things like org [organisational] structure, policies and procedures and health promotion.” “Many changes … structural and process changes were made as a result of the SAT enquiry.” (respondent 17).

Issues relating to SAT use and facilitation

“Time required. Difficulty maintaining staff interest” (respondent03)

Resulted in some disagreement and debate. Managers (or other positions of authority/power) tended to have final say.” (respondent04)

“[the services] use an external facilitator for the SAT process. This makes it easier for staff within the organisation to participate openly in the process. Expert facilitators who have a good understanding of the service delivery context should be used when implementing the SAT. It is often the case that there are issues within a health service or between people within the health service that will be aired during the SAT. This can be dangerous if the facilitator does not know to expect this and have the necessary skills to divert the discussion. Also there will generally be someone in the discussion who dominates and the facilitator needs to be able to balance the impact of the dominant voice …” (respondent17)