Table 6 Summary of relational facilitators

Relationship building

Pre-existing relationship

We had established and good relationships … so we are already at first base eE 1

Economists’ attributes as perceived by staff participants

Intellect and knowledge of subject matter

Just a really smart head... he knows his stuff. PHN PARTICIPANT 5

Ability to clarify and demystify difficult concepts

[eE] has a really nice way of communicating those things in a very – I wouldn’t say simplistic, but it is quite simple and it’s not onerous for people who don’t have that kind of evaluation perspective, or don’t have that experience or background in thinking about evaluation or thinking about value-based healthcare or those sorts of things. PHN PARTICIPANT 11

Ability to make subject matter interesting

He makes health economics sound extremely interesting. It was really inspiring listening to him…He’s really touched some people who would … have heard the words health economics and run in the other direction PHN PARTICIPANT 20

Responsive, engaging, approachable, and encouraging communication style

Well obviously good and positive was [eE’s] willingness and ability to jump into something very quickly in a very short turnaround time and give us some feedback, which was great... So he’s quite responsive. PHN PARTICIPANT 1

Having an economist who can really engage well with staff was a key enabler. Not – not all economists can do that, so that was – that was a key enabler. PHN PARTICIPANT 4

He’s been very approachable and has been very open to having discussions with anybody and everybody. PHN PARTICIPANT 9

It comes back to the response that she received, and the encouragement she received helped her go further. SITE LEAD

Treating staff as equals

He can relate to anyone at their level. He doesn’t come across as being superior PHN PARTICIPANT 15

Displaying genuine interest in participants’ work

I think too that [eE] is able to demonstrate an actual interest in the work that people are doing and has been quite vocal about the value that he’s getting out of the experience. I think that really has resonated with people so they don’t feel like – I guess there was a risk that we could have been … treated like lab rats in some ways, but that’s definitely not the experience. PHN PARTICIPANT 3

Incisive and gently directive

I've really enjoyed and really appreciated the take-charge and the authority. Not in an overpowering way at all, just probably his comfort in moving things along quickly…So his ability to be able to give me some answers and some direction incredibly quickly was incredibly helpful. PHN PARTICIPANT 12

Relevant

He’s been well received. I think because even on a personal note he’s just really interested in the topic, but he’s also interested in making it relevant for us. PHN PARTICIPANT 17

Adaptive

…he was adaptive. So what I mean by that is he – he didn’t take a rigid university based or academic style health economic approach. He listened to people then adapted the approach to impact assessment or health economic support to the need of the – the program, project or initiative. Which is different from the traditional health economic approach where you pull your academically developed resource, or whatever it is, off the shelf, and fit – try to fit the initiative into that. So it’s a different – it’s a different approach, and to me that was a key part of the success to be honest, in [eE’s] style. PHN PARTICIPANT 4

Economists’ attributes as perceived by economists

A quick thinking, solution-based, confident and facilitative approach

The need to think on your feet super quickly. You’ve got … an hour and … your mind’s got to be going through what potential solutions might be. You’ve got to be confident enough to say, if there isn’t a solution, ‘you’re going to have to wait and I’m going to have to come back to you’ … And there’s been times that people have told me their problems and I actually know, that’s not my skill set, ‘So you need to talk to [someone else] …if I said something I’d be guessing.’ And you need the confidence to be able to say that. eE 1

Ways of working

Coaching

It is about that mentoring, coaching approach … [the eE] just takes people through step by step, doesn’t land a whole lot of information on somebody’s desk and expect them to digest it. He sits down with you, with the information in front and goes through it. So not a dump and run, a gentle reading. PHN PARTICIPANT 20

I want [LEAD and SUPPORT ECONOMISTS] to support me rather than them do all the work and then just hand me a cost model at the end because then I don’t learn anything PHN PARTICIPANT 18

Understanding that what health services need and what the academic institutions think they need are really two different things. That it can be quite insulting to them to have an academic tell them, ‘There's a better of doing this you know.’…The attitude I think that's going to be important is, ‘Right, you've got a problem, let's do the best we can to get this problem sorted.’ Not telling them how to reshape their business model…. eE 1

Bi-directional learning

…we're learning as we do this program… for my personal development, it has been a river of gold…When I went into the PHN it was a … a new learning for me that we were not as applied as I thought we were…people were asking me issues around evaluation and economic evaluation that were almost like first steps that we tend to ignore…normally we would have just launched straight into, ‘Oh, that’s the project, you want an evaluation of that, this is what the evaluation’s going to look like.’ What we were missing previously is that understanding that they needed help with that background work of ‘what are the pathways to determining you actually have a project that even warrants an economic evaluation.’ eE 1

It was really interesting to find out more about health care systems at the local level. So, it’s been a good satisfying learning experience for me… So, I’m a better health economist for having done those jobs. I can certainly say that. eE 3

In a normal situation, usually if I do a job for somebody … they won’t learn much about what I do. …. If they’ve never seen a cost analysis before, of course they’ll see it for the first time and I’ll talk about how I did it. But they won’t get a chance to work with me. In this case I actually encouraged [DE-IDENTIFIED]… to make changes in the spreadsheet…we worked together closely… It was more hands on in this case. So, it wasn’t like a normal job. It was very much one where it was set up on the initial understanding of the closer working relationship with a practical aspect. eE3