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Table 2 Comparison of the emergent key concepts and number of quotations across different states

From: Perceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in Australia: a qualitative social dynamic perspective

Theme Key Concepts Number and % of respondent for each concept by States Number and mean number of quotations by States
All states (n=119) NSW/ACT (n=52) WA (n=30) QLD (n=37) All states NSW/ACT WA QLD
No. No. % No. % No. % No. No. Mean No. Mean No. Mean
Personal experiences of stress and morale 4HR/NEAT increased stress and decreased morale 109 44 85% 30 100% 35 95% 1146 323 7.3 512 17.1 311 8.9
4HR/NEAT increased workload 81 28 54% 22 73% 31 84% 419 135 4.8 132 6.0 152 4.9
4HR/NEAT improved morale in ED staff 18 7 13% 7 23% 4 11% 52 13 1.9 32 4.6 7 1.8
4HR/NEAT improved the clinical role performance 8 0 - 7 23% 1 3% 11 0 - 9 1.3 2 2.0
4HR/NEAT decreased stress 4 1 2% 2 7% 1 3% 5 1 1.0 2 1.0 2 2.0
Intergroup dynamics 4HR/NEAT necessitated the Whole of Hospital Approach (WoHA) 87 31 60% 28 93% 28 76% 334 120 3.9 124 4.4 90 3.2
4HR/NEAT impaired relationships with rest of the hospital 77 33 63% 21 70% 23 62% 257 86 2.6 84 4.0 87 3.8
Hospital failed to employ the WoHA 54 26 50% 9 30% 19 51% 190 113 4.3 13 1.4 64 3.4
Suboptimal leadership and insufficient buy-in at hospital executive confounded 4HR/NEAT-related changes 47 21 40% 9 30% 17 46% 128 59 2.8 18 2.0 51 3.0
4HR/NEAT undermined ED teams and teamwork 35 13 25% 14 47% 8 22% 82 36 2.8 31 2.2 15 1.9
4HR/NEAT improved relationships with rest of the hospital 33 15 29% 10 33% 8 22% 40 15 1.0 14 1.4 11 1.4
4HR/NEAT improved communications within ED staff 29 11 21% 16 53% 2 5% 50 18 1.6 29 1.8 3 1.5
4HR/NEAT worsened communication within ED staff 26 9 17% 13 43% 4 11% 43 16 1.8 22 1.7 5 1.3
4HR/NEAT improved ED teams and teamwork 25 5 10% 12 40% 8 22% 39 9 1.8 17 1.4 13 1.6
4HR/NEAT signified the importance of hospital’s executive buy-in 21 11 21% 6 20% 4 11% 59 32 2.9 16 2.7 11 2.8
4HR/NEAT increased autonomy of ED staff 16 9 17% 4 13% 3 8% 25 16 1.8 4 1.0 5 1.7
4HR/NEAT shifted the flow of power from ED to hospital executives 6 6 12% 0 - 0 - 7 7 1.2 0 - 0 -
4HR/NEAT led to overwhelming pressure from department of health 4 0 - 2 7% 2 5% 5 0 - 3 1.5 2 1.0
Interaction with patients 4HR/NEAT decreased staff-patient communication 43 12 23% 14 47% 17 46% 140 36 3.0 46 3.3 58 3.4
4HR/NEAT improved staff-patient communication 26 9 17% 6 20% 11 30% 56 15 1.7 23 3.8 18 1.6
4HR/NEAT had no change on staff-patient relationships 17 6 12% 7 23% 4 11% 20 8 1.3 8 1.1 4 1.0
Non-4HR/NEAT factors influencing staff-patient communication 6 2 4% 3 10% 1 3% 6 2 1.0 3 1.0 1 1.0