Table 2.
Joint Display of Survey Quantitative Barriers and Facilitators and Interview Qualitative Themes and Exemplar Quotes
| Interview: qualitative themes: facilitators (n)a | Survey: reasons for involvement, n (%)b | ||
|---|---|---|---|
| Motivation to improve care (n=27) | Quality improvement “improves the quality of life of physicians.” [A motivation is to use QI] “to unload work from doctors that they don’t need to do.” |
• Makes a difference• Improves patient satisfaction• Committed to quality• Enjoys process improvement | 41 (85%) 32 (67%) 27 (56%) 20 (42%) |
| Team-based care (n=17) | “Projects that are tied to specific roles and people to execute specific tasks have gone well.” “We have very strong medical assistants. We have done more with our MA’s than with our nurses.” |
• Improves team efficiency• Reduces burnout• Better job satisfaction Reduces wasteful care | 32 (67%) 30 (63%) 20 (42%) 18 (38%) |
| Having a practice champion (n=5) | “[Our quality champion]” is a strength, she is great with people, organization and managing quality.” | • Produces scholarly work | 16 (33%) |
| Interview: qualitative themes: barriers, (n) a | Survey: barriers to participation, n(%) b | ||
| Competing priorities in patient care and teaching (n=17) | “It feels like [our system] prioritizes and expects clinical productivity and revenue.” “If there is not protected time specifically for quality projects or research, it is difficult for clinical faculty to do this work.” |
• Patient care prioritized• Teaching/ other roles prioritized• Not asked to participate• Lack of motivation | 25 (53%) 20 (43%) 11 (23%) 6 (13%) |
| Faculty expertise in quality and scholarship (n=14) | “We need more faculty development… [to make us] more comfortable and more effective at leading QI efforts. “PA [faculty] are trained to see patients but not necessarily to improve quality in large systems.” |
• Lack of QI training | 17 (36%) |
| Developing infrastructure for quality and scholarship (n=13) | “If we don’t invest and fund the post-production of turning [QI] into scholarship then it is difficult for clinical faculty to have the time to do it on their own.” | • QI not effective• QI does not improve care | 6 (13%) 3 (6%) |
a
N refers to total codes for each theme.
b
Survey respondents could choose more than one facilitator and barrier.