RETRACTED ARTICLE: A thematic analysis of system wide learning from first wave Covid-19 in the East of England

Jackson, Carolyn; Manley, Kim; Webster, Jonathan; Hardy, Sally

doi:10.1186/s12913-022-07797-7

BMC Health Services Research

Table 3 Example of the themes arising from the third level analysis for Question 1

From: RETRACTED ARTICLE: A thematic analysis of system wide learning from first wave Covid-19 in the East of England

Numbers in brackets indicate the number of datasets contributing to the theme derived from the secondary analysis. This gives a tentative impression of the strength of each theme, but caution needs to be applied in its interpretation as although many datasets were from individual informants, a small number were from groups of informants, through grand rounds, Instagram accounts and meetings. The asterisks indicate where responses included data from groups. Each overarching theme comprises the themes derived from the second level analysis which were undertaken by four different analysers, thus accounting for the different colours enabling an audit trail to be established back to the original data.
What has worked?
Theme 1: Collaborative, resilient, flexible teams who mutually support each other, cascade information and have risen to the challenge. (72)* • Leadership, commitment to team working and support for self, each other and the wider interdisciplinary team (24) • Collaborative, resilient, flexible and effective teams who pull together support each other (18*) • Positive atmosphere in which the whole team were communicating, rising to the challenge and adapting to working in a new way (5) • Support from managers and availability of supervision and debriefs (4) • Keep laughing and joking (4) • Support with equipment, information and processes around Covid, including time to work on workforce plans, funding (8) • Cascading information via WhatsApp across teams (3) • Regular meetings to enhance team work and communication (1) • Training to help others used to working in a ward environment (1) • Resilience of self and the team (3) • Jobs not getting done- being handed over to team/next shift (1)
Theme 2: Cross-boundary working with, shared priorities, improved relationships, pooled resources, streamlined processes enabled new services (24*) • Collaborative planning, improved and faster working for pooled resources to implement new services (8*) • Cross boundary working and partnerships about shared priorities for care has improved working relationships across the system (7) • Ability to cross team work and initiate new projects (5**) • Streamlined processes focussed on delivering the task/ outcome (2) • Building strong relationships with suppliers and contacting them directly to get PPE deliveries (2)
Sub-theme 2.1: Ideas implemented have spanned technical innovations and standard passports for volunteers in acute settings to sharing medications in short supply and adapting new ways of working in the community (5) • Ideas implemented in acute hospitals included: reverse laminar flow in theatres and creating parallel departments; and standard passports for volunteers, Medical-air dependent ventilators rather than Oxygen dependent (3) • Ideas implemented in community settings included sharing medicines in short supply for EoL, easy read material for residents, taking services into people’s homes, using photographic evidence for DN consultations (2)
Theme 3: Seeing the person in the patient, and with care and patience working with or for family members across the spectrum of care from recovery to death (24) • Experiencing and learning from the spectrum of care from recovery to death (9) • Seeing the Patient as a “person’ not just a number in which there was greater ‘care’ and ‘patience’ (7) • Different ways of working as an extended family to deliver the best service to patients (5) • Worried families know residents are in good hands (2**) • Encouraging patients to take more responsibility and use family and community support (1)
Theme 4: Technology has contributed to normality and innovation through patient consultation/decision making, improved response times, EoL experiences, team communication, remote working, staff wellbeing, and recruitment. (20*) • Technology’s role in connecting to and supporting patient consultation, triaging and rapid decision-making (6) • Technology’s role in contributing to stakeholder and team communication to improve wellbeing (5) • Technology’s role in contributing to normality and EoL experiences for residents’, patients and relatives (3**) • Technology’s role in thinking outside the box, training, and recruitment (2) • Technology’s role in supporting remote working (2) • Technology’s role in Primary Care Instant Response lines (1) • Technology’s role in promoting weekly webinars to enable staff to keep up to date with what is going on (1)

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Numbers in brackets indicate the number of datasets contributing to the theme derived from the secondary analysis. This gives a tentative impression of the strength of each theme, but caution needs to be applied in its interpretation as although many datasets were from individual informants, a small number were from groups of informants, through grand rounds, Instagram accounts and meetings. The asterisks indicate where responses included data from groups. Each overarching theme comprises the themes derived from the second level analysis which were undertaken by four different analysers, thus accounting for the different colours enabling an audit trail to be established back to the original data.
What has worked?
Theme 1: Collaborative, resilient, flexible teams who mutually support each other, cascade information and have risen to the challenge. (72)* • Leadership, commitment to team working and support for self, each other and the wider interdisciplinary team (24) • Collaborative, resilient, flexible and effective teams who pull together support each other (18*) • Positive atmosphere in which the whole team were communicating, rising to the challenge and adapting to working in a new way (5) • Support from managers and availability of supervision and debriefs (4) • Keep laughing and joking (4) • Support with equipment, information and processes around Covid, including time to work on workforce plans, funding (8) • Cascading information via WhatsApp across teams (3) • Regular meetings to enhance team work and communication (1) • Training to help others used to working in a ward environment (1) • Resilience of self and the team (3) • Jobs not getting done- being handed over to team/next shift (1)
Theme 2: Cross-boundary working with, shared priorities, improved relationships, pooled resources, streamlined processes enabled new services (24*) • Collaborative planning, improved and faster working for pooled resources to implement new services (8*) • Cross boundary working and partnerships about shared priorities for care has improved working relationships across the system (7) • Ability to cross team work and initiate new projects (5**) • Streamlined processes focussed on delivering the task/ outcome (2) • Building strong relationships with suppliers and contacting them directly to get PPE deliveries (2)
Sub-theme 2.1: Ideas implemented have spanned technical innovations and standard passports for volunteers in acute settings to sharing medications in short supply and adapting new ways of working in the community (5) • Ideas implemented in acute hospitals included: reverse laminar flow in theatres and creating parallel departments; and standard passports for volunteers, Medical-air dependent ventilators rather than Oxygen dependent (3) • Ideas implemented in community settings included sharing medicines in short supply for EoL, easy read material for residents, taking services into people’s homes, using photographic evidence for DN consultations (2)
Theme 3: Seeing the person in the patient, and with care and patience working with or for family members across the spectrum of care from recovery to death (24) • Experiencing and learning from the spectrum of care from recovery to death (9) • Seeing the Patient as a “person’ not just a number in which there was greater ‘care’ and ‘patience’ (7) • Different ways of working as an extended family to deliver the best service to patients (5) • Worried families know residents are in good hands (2**) • Encouraging patients to take more responsibility and use family and community support (1)
Theme 4: Technology has contributed to normality and innovation through patient consultation/decision making, improved response times, EoL experiences, team communication, remote working, staff wellbeing, and recruitment. (20*) • Technology’s role in connecting to and supporting patient consultation, triaging and rapid decision-making (6) • Technology’s role in contributing to stakeholder and team communication to improve wellbeing (5) • Technology’s role in contributing to normality and EoL experiences for residents’, patients and relatives (3**) • Technology’s role in thinking outside the box, training, and recruitment (2) • Technology’s role in supporting remote working (2) • Technology’s role in Primary Care Instant Response lines (1) • Technology’s role in promoting weekly webinars to enable staff to keep up to date with what is going on (1)