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Table 3 Factors that enable or create a barrier to the normalisation of STRIVE sexual health CQI components

From: Perspectives of primary health care staff on the implementation of a sexual health quality improvement program: a qualitative study in remote aboriginal communities in Australia

STRIVE Component Enabler Barrier
Clinical data report • Data specific to each clinic
• No clinic specific data pre STRIVE
• Clearly highlighted gaps and improvements
• Directly translatable into clinical activity
• Face-to-face delivery of reports
• High staff turnover decreased relevance of the data
• High staff turnover meant that some interviewees had no recall of the data reports
• Data quality was questioned
• Some interviewees felt the reports were difficult to interpret
• Clinic data overload (too much data)
• Competing clinical demands and a busy clinic
Systems Assessments Tool • Tool aligned with existing CQI process
• Tool was familiar to interviewees
• Promoted reflective practice
• Clearly highlighted gaps and improvements
• All of staff involvement
• High staff turnover and yearly SAT meant that some interviewees had no recall of the tool
• Subjective nature of scoring system created less engagement
• Some clinic systems were unable to be altered by clinic based staff, therefore relevance of the tool was questioned
• Tool not understood easily by all
• Tool was very lengthy and felt to be repetitive
Action Plan setting • Action plan translated the data and systems assessment into clinic specific goals
• Provided a clear framework
• Decreased manager workload
• High staff turnover meant some interviewees had no recall of the Action Plan
• Competing clinical demands decreased the workability of the action plan
• Limited engagement in the plan by some visiting sexual health support staff
STRIVE coordinator • Clear understanding of difference in roles between STRIVE coordinator and existing regional sexual health support staff
• Regular face-to-face visits
• Continuity of STRIVE staff
• Created accountability
• Visiting support staff ‘fatigue’
Health Promotion funding • Encouraged staff to conduct a health promotion activity
• Funding not tied to any formal reporting requirements
• Lack of clarity about the difference between STRIVE health promotion and STRIVE incentive based funding
• Interviewees questioned the value of health promotion
• Lack of resources (knowledge, staff, time) to utilise the funding
• Difficulties in accessing the funding
Clinic incentive payments • Funding not tied to any formal reporting requirements
• Motivator for staff
• Lack of clarity about the difference between STRIVE health promotion and STRIVE incentive based funding
• Difficulties in accessing the funding
• Some interviewees felt ethical uncomfortable with incentivisation of their work
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