Table 3 Summary of inductive thematic codes
Inductive codes | Description | Example | System level |
|---|---|---|---|
Strategies | |||
Creative use of resources | Individuals and teams displaying creative use of resources (e.g., equipment, networks). | “… put in some money, and ended up getting enough for two courses and face-to-face. So without that kind of coordination and collaboration around costing…that kind of opportunity just wouldn’t exist.” (Site C, Coordinator 2) | Individual, Team |
Prioritise tasks/goals | Teams establishing priorities at the expense of others (i.e., making trade-offs) and being opportunistic. | “In terms of the nine strategies that were identified, [we] clustered them into three or four…that [made] it more manageable…things can be prioritised and started at different time points…we were running out of time, it was completely pragmatic” (Site C, Coordinator 1) | Team |
External engagement and collaboration | Growing network with external individuals, groups and organisations, and engaging community and clinical champions. | “actually making time to meet with her regularly... And to just create that relationship” (Site B, Coordinator 2) | Team |
Teambuilding and collaborative learning | Building relationships between teams and with management. | “so the next week, I started individual calls with each site and asked them like…what’s going on, what do you need…And then set up those calls so that they repeated weekly” (BDI Manager 3) | Management |
Monitoring & feedback | Management quantitatively monitoring progress at each site and provide feedback. | “dashboards…with monitoring of how the sites were going” (Site D, Coordinator 2) | Management |
Impediments | |||
Complexity | Complexity of the health system and complexity of the intervention. | “the scope of the project was so huge, and it covered so many different sectors and organisations” (Site C Coordinator 2) | Across |
Misalignments in priorities/needs | Misalignments in priorities and needs between the team, management and broader system levels. | “Whereas, the things that were a priority to us, weren’t necessarily the same priority to BDI” (Site A, Coordinator 1) | Across |
Inadequate resources | Deficiency of resources (money, staff, skill-mix) at the individual, team, management and broader system level. | “It wasn't sufficient to implement the whole nine strategies. It wasn't sufficient to evaluate and see whether they had an impact. It wasn't sufficient in all likelihood to actually reduce deaths.” (Site B, Coordinator 1) | Across |
Staff turnover | Critical staff (including site coordinators and managers) and program and clinical champions leaving at critical times. | “I think one of the things that often happens in change programs is that key people leave at critical times. And [BDI Senior Manager] left. And she was a kind of mobilising force and enthusiastic and getting everyone excited…it certainly had an impact on me after that” (BDI Manager 2) | Across |
Consequences | |||
Built personal and collective resilience | Ability to withstand, adapt to, and recover from adversity, at the individual and team level. | “Because as much as it’s a shift for us, I know it’s a shift for them as well. And it’s just been a really painful process, because we’ve all had to go through this shifting together” (BDI Manager 4) | Individual. team |
Stress and burnout | Workplace stress and exhaustion caused by feeling overwhelmed and emotionally drained. | “we were burnt out…you lose momentum” (Site A, Coordinator 2) | Individual |