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Table 8 Supporting Quotations for “Resource Requirements”

From: Measurement without management: qualitative evaluation of a voluntary audit & feedback intervention for primary care teams

• … my QIDSS person spends a lot of time giving D2D data. (ID = 001)
• With D2D there’s more work involved, and we’re trying to minimize that, but there certainly is more work involved. (ID = 014)
• If they keep doing it at the rate that it’s going right now, I’ll probably not participate. I’ll probably talk to our group about not participating and having our quality improvement data support specialist do something else, because that is really all she has been doing, is getting it ready and doing these submissions. (ID = 013)
• I don’t think that, from a team perspective, the teams have the time and capacity to attend to this to the level that perhaps HQO thinks we should. So it’s one thing to say you have the staff resources in a QIDSS specialist to assist … But when you look at how people are spending their time in organizations, and you ask them to engage in D2D or other quality improvement initiatives, it takes time, people attend meetings … there’s a whole bunch of pieces. When they’re doing that, they’re not seeing patients. And so, the quality improvement initiative is, the Ministry going back to your thing around the policy climate, is really trying to drive increased accessibility. When I have 10 people in a meeting for two hours to talk about quality improvement, that means they’re not seeing patients, which reduces access of our patients to our team. So, in terms of resources, there needs to be greater organizational capacity to be able to plan, develop, and implement quality improvement initiatives beyond a part-time QIDSS specialist. Otherwise, we really are working in conflict in terms of trying to give patients greater access to our providers, while, at the same time, distracting our providers by trying to engage them in things like quality improvement initiatives or other things that seem to come down from the Ministry within that particular policy climate. (ID = 005)
• Because it’s difficult to extract information from the EMR our HPs and our RN’s have to spend a lot of time extracting this data. I think there is value in it because I think we have to demonstrate … so, it’s just that it’s hard to pull the data and we don’t have a quality improvement person. So, it’s taking time away from patient care. (ID = 013)
• I think now as a QIDSS, being a resource myself, I think it’s enough that I’m able to collect the data and submit on it but being able to act and implement those changes that are required to lead quality improvement, there definitely needs to be some more resources put in place, especially if it continues to grow. One person can only do so much with the time so that face time I have at each FHT and the influence I have, there really needs to be more of us I would say. (ID = 014)
• R1: Our data person is a dietician.
R2: Yes. She is a half-time dietician, half-time data person.
R1: She was never a data-person. We just gave her the job and she learned it on the job, which was great. I think that is also one of the concerns, too. From a knowledge transfer perspective, if she left tomorrow, we would be in a lot of trouble. (ID = 003)
• And, we have seen with D2D, we were usually at the top. But, we also have a lot of resources to help us get to that top. So, some of our comparators do not have any data managers gleaning their data. They don’t have all of that. (ID = 007)