Table 4 Summary of themes and sub-themes in relation to individual tools

1. Tool Design

1.1 Utility

Inform patient safety

Training aide

Provide evidence of safe practice.

Did not uncover enough learning points for those using SEA.

Provided a useful practice-wide staff perspective.

Provided a novel patient perspective.

Produced useful patient specific information.

Produced useful information.

Produced useful information that prompted reflection on safety issues.

1.2 Usability

Format

Time to completion

Integration with existing systems

Was time consuming in the selection of individual records.

Completed online and easy to follow.

Resource intensive due to the addressing and packing of multiple envelopes.

Required either existing IT knowledge or additional help and support.

Straightforward to use.

Easy to use and quick to complete

2. Organisational factors

2.1 Staff training

Existing skill set

Was straightforward to use though a preference for an electronic version was expressed.

No training needed though an email address for each staff member was required.

Issues arose selecting random patients and using ‘mail merge’ to address letters and envelopes.

Staff training was required to run the software and upload the results.

No formal training required. An electronic version preferred.

No training required

2.2 Available resource

Staffing levels,

Time constraints

2.3 Existing patient safety approaches

Comparative effectiveness

3. Environmental context

3.1 Clinical commissioning group

Existing initiatives

N/A

N/A

N/A

N/A

Repeated the work of a CCG initiative in one area.

N/A

3.2 Central policy

Financial Incentives

Fragmented policy