Table 4 Process Evaluation Matrix
From: EQUIP Emergency: study protocol for an organizational intervention to promote equity in health care
| Enablers | Component/Activity | How or why are we doing this? | Key Performance Indicators | Data Sources | |
|---|---|---|---|---|---|
|
Pre-Intervention Assessing Readiness and Engagement | Change Readiness, Leadership & Policy, Engagement | Engage hospital leadership in project | Secure leadership buy-in & support for grant; Assess change readiness of site; Build leaders’ knowledge of core principles (EOHC, FLO) |
• Commitment from hospital leadership to participate in project • Agreement from leadership to sign on to grant application |
• Qualitative interviews • Meeting minutes |
| Leadership & Policy, Funding, Engagement | Secure fiscal commitment from sites | Fund working group staff time; Support FLO in intervention | • Stated commitment to fund Working group at each site |
• Qualitative interviews • Meeting minutes | |
| Leadership & Policy, Engagement | Build rapport with unit leaders | Assess change readiness of unit; Foster participation & support for project | • Stated commitment to participate in project |
• Qualitative interviews • Meeting minutes | |
|
Intervention PHASE I Working Group Engagement |
Engagement Knowledge & Training | Spread awareness of EQUIP project at unit level | Foster awareness of EQUIP research activities; Begin to generate interest in working group; Lay groundwork for working group activities |
• Diverse categories of staff attend orientation sessions • Communications received by research team about the study by ED staff |
• Field notes • Qualitative interviews |
|
Change Readiness, Engagement Enrollment, Front Line Ownership, Stewardship | Facilitate staff interest in working group | Facilitate development of working group; Foster FLO processes; Prepare for intervention activities | • Working group forms at each site |
• Field notes • Qualitative interviews | |
|
Intervention PHASE II A Establishing a Sustainable Working Group | Knowledge & Training, Front Line Ownership, Stewardship | Identification of change coaches and equity coaches to support working group activities | Support the working group’s change process: translating assessments to action, anticipating and managing disruption |
• Identification of equity coach and change coach for each site • Finalized job description for change coaches | • Qualitative interviews |
|
Funding, Engagement, Human Resources Enrollment, Knowledge & Training, Data & Information, Front Line Ownership, Stewardship | Deliver orientation workshop during first working group meeting | Orient working group to core principles of EOHC & FLO; Foster FLO & project ownership; Facilitate working group team building; Provide roadmap for project activities (e.g. assessment) |
• Staff knowledge of core principles • Staff commitment to core principles • Staff commitment to continue working group |
• Field notes • Meeting minutes • Qualitative interviews | |
|
Funding, Engagement Enrollment, Front Line Ownership, Data & Information Stewardship | Working group meets a second time to prepare for action | Foster FLO & project ownership; Provide opportunity to reflect on first meeting; Facilitate working group preparing for action |
• Working group sets future meeting date(s) • Working group develops plan for further ED assessment |
• Field notes • Meeting minutes • Qualitative interviews (working group members, coaches) | |
|
Intervention PHASE II B Working Group Begins Action |
Funding, Engagement, Human Resources Knowledge & Training, Front Line Ownership, Stewardship | Working group develops internal mechanisms for supporting team (terms of reference, mandate) | Fostering FLO throughout intervention; Supporting success of working group intervention activities by building a functioning team | • Working group develops documents to guide teamwork throughout intervention |
• Field notes • Meeting minutes • Qualitative interviews |
|
Change Readiness, Funding, Human Resources Knowledge & Training, Front Line Ownership, Stewardship | Working group identifies problem(s) and begins action to address this problem | Working group begins locally tailored intervention activities grounded in FLO principles |
• Working group conducts equity walk-through(s) • Working group completes ED assessments, through existing data analysis and further assessment • Working group identifies key challenges to equity within each site |
• Field notes • Meeting minutes • Qualitative interviews | |
|
Engagement, Human Resources Front Line Ownership, Stewardship | Research team phases out leadership | Ensure FLO is operationalized throughout intervention activities |
• Working group organizing and facilitating their own meetings • Research team in note-taking role • Working group members directing research team involvement • Working group identifies own knowledge and resources needs |
• Field notes • Meeting minutes • Qualitative interviews | |
| Data & Information | Research team decides when to collect first post-intervention data | Ensure data collection is timely and according to study design, while also best capturing outcomes from progress toward stated goals at each site | • Dates finalized for post-intervention data collection at each site | • Meeting minutes | |
|
Intervention PHASE III Working Group Implementation |
Funding, Leadership & Policy, Human Resources Knowledge & Training, Data & Information, Front Line Ownership, Stewardship | Working group develops project plan and budget for hospital/unit leaders and research team | Support FLO principles throughout intervention while ensuring accountability of working group for catalyst grant and project activities |
• Working group submits project plan and budget to hospital/unit leaders and research team • Research team confirms release of funds to working group • Hospital/unit leaders provide feedback on project plan |
• Field notes • Meeting minutes • Qualitative interviews • Project plan & budget documents |
|
Change Readiness, Funding, Human Resources Knowledge & Training, Front Line Ownership | Working group spends $10,000 catalyst grant to support activities | • Working group spends catalyst grant funds |
• Field notes • Meeting minutes • Expense reimbursements • Working group 6-month progress report | ||
|
Change Readiness, Leadership & Policy, Funding, Engagement, Human Resources Knowledge & Training, Front Line Ownership | Working group implements identified equity strategies | Drive the intervention, supported by core principles of EOHC & FLO |
• Working group communicates equity strategy plan to hospital/unit leaders • Working group communicates equity strategy plan to staff • Working group spends catalyst grant funds toward equity strategies |
• Field notes • Meeting minutes • Qualitative interviews • Working group 6-month progress report | |
|
Engagement, Human Resources Knowledge & Training, Front Line Ownership | Working group conducts peer evaluation to contribute to assessment of team effectiveness | Provide feedback to working group regarding team effectiveness to date; Support adaptation of working group to emergent needs and contribute to success of intervention activities; Contribute to success of working group team beyond 6-month intervention period |
• Working group completes peer evaluation • Working group adapts team mechanisms and processes based on feedback from peer evaluation |
• Field notes • Meeting minutes • Peer evaluation documents (researcher use of documents as data to be negotiated with working group) • Qualitative interviews |