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Table 2 Summary of motivations to participate in a voluntary audit and feedback intervention by CFIR domain

From: Beyond quality improvement: exploring why primary care teams engage in a voluntary audit and feedback program

Theme Summary
Outer Setting
Policy Advocacy D2D was identified as a vehicle to support two policy priorities: 1) The future direction of Primary Care quality improvement and performance measurement; and 2) The value and contribution of FHTs to Ontario’s Health Care System.
“We wanted to be able to work with AFHTO to start being able to direct where Health Quality Ontario was asking us to go on our quality improvement by using data that was more accurate or more up to date, to create those conversations…” (ID = 015)
Peer Influence Knowledge of peer participation in D2D facilitated participation in a minority of cases.
“Other people participating doesn’t really drive our D2D work…”(ID = 018)
Good Soldier Phenomenon Observed in two ways: 1) Some informants had external responsibilities to AFHTO. Participation in D2D was part of their efforts to support AFHTO initiatives. 2) Some FHTs agreed to participate to fulfill their responsibility as a member of AFHTO.
“…we participate, really to be good corporate citizens.” (ID = 001)
Inner Setting
Availability of Implementation Leader A dedicated staff person to support implementation was seen as essential component for participation. Without this resource, most practices interviewed would not participate.
“…our [QIDSS] really kind of pushed it too, and he was there to help us get the information. That made it a bit easier.” (ID = 015)
Development of QI Capacity D2D was viewed as a means to improve teams’ development of quality improvement capacity.
“We wanted to be able to measure how we’re doing, to be able to compare ourselves with similar groups throughout the province, but knowing that, for us, we were just starting the measurement process. And we wanted to know what we’re able to do and what our limitations were.” (ID = 012)
Intervention Characteristics
Promise of Future Potential Participation was influenced by a promise of a “best-in-class” data tool which will be developed by ongoing participation. Desirable features included: Peer comparison and Benchmarking, the use of up to date data, the consolidation of data from a variety of sources and that the tool would be directly informed by participant feedback.
“…I think that need is right now mostly based on a promise. The promise is what is going to happen with future iterations, and that its going to continue to develop until it actually is a robust, useful, accessible, meaningful exercise. I think we’ve taken initial steps towards that, but we need it to continue in that area” (ID = 014)
Evidence Base No FHTs considered an evidence base in deciding to participate in D2D.
“I don’t think I have to go to my IT expert and say, do you think measuring how we’re doing is a good idea? It just kind of is. I don’t know how else to say it. I never presented to the group what was the evidence base behind D2D. To me…this is good for QI, this is good for accountability…” (ID = 017)