Table 3 Description of themes used for focus groups coding
Theme | Description |
|---|---|
1. Process of care | Definition: “What is actually done in giving and receiving care. It includes the patient’s activities in seeking care and carrying it out as well as the practitioner’s activities in making a diagnosis and recommending or implementing treatment” [30] |
1.1. Influencing patients | Example: cost of medications and access to services from the patient perspective |
1.2. Influencing providers | Example: not sure who is doing what, challenges with patient diagnosis, patient transfer to another unit |
1.3. Influencing care system | Example: lack or presence of pulmonary rehabilitation services, access to pharmacist, lack or presence of family doctor |
2. Human capacity in care setting | Definition: the ability of the people implementing the discharge care bundle items (nurses, RRTs) to make sure the items are attended to |
2.1. Time constraints | Example: not enough nursing/RRT staff time to implement additional steps in care, patients do not spend enough time in ED |
2.2. Volume and staffing issues | Example: nursing/RRT staff shortage |
2.3. Education and training of health care providers | Example: training of staff on inhaler techniques, training of staff on discharge care bundle |
3. Communication and engagement | Definition: the level of engagement and communication within single setting (such as buy-in) or across specializations (such as acute primary care) |
3.1. Patients’ engagement | Example: communication between patient and provider, patient engagement/interest in self-managing, information overload |
3.2 Providers’ engagement | Example: buy-in from frontline/physicians |
3.3. System’s engagement | Example: communication and collaboration across sites, multidisciplinary communication and collaboration |
4. Attitude and perception of change | Definition: set of psychological/administrative responses to planned change. This includes positive and negative responses |
4.1. Patient attitudes | Example: do not want to do new things/willingness to do so, opinion that the intervention is not worth the effort |
4.2. Provider attitudes | Example: opinion that intervention not useful, attitude towards checklist—positive and negative |
4.3. System attitudes | Example: administrative obstacles, support from executive management |