Table 3.

Examples of How the Qualitative Data Were Used to Build Quantitative Survey Items in the Survival after Acute Myocardial Infarction Study

Domains and Quotations from Qualitative Article	Corresponding Survey Item
Broad staff presence and expertise
“I started writing my consult note in the physician progress notes… over the years it's just become the standard… That was a way of my breaking into the culture saying, ‘This is my note; I want you to read it. It's not in the nurse's section. I have some ideas… and I'm open to talking about it.’” (Nurse Manager, ID #5)	Nurses are comfortable checking with physicians if they have concerns about patient care. (survey item 65)
Communication and coordination among groups
“Everyone in this hospital from the housekeeper to the CEO plays a role… The housekeeping needs to know why it's important for them to go out and do their job… No one has an insignificant role in it… So everybody needs to be educated. Everyone.” (Director, Catheterization Laboratory, ID #2)	Clinicians involved in the care of patients with AMI value each others’ skills and talents (e.g., physicians’ value nurses’ skills and talents and vice-versa). (survey item 58)
Problem solving and learning
“…the performance improvement team… identifies action steps, the plan is put in place, and then we continue to measure to see if it's working or not working… you identify, you intervene, you improve, you monitor, you tweak and that's the model that they've been using for 10 years.” (Director, Quality Management, ID #4)	After we make changes to improve AMI care, we fail to evaluate their effectiveness. (survey item 67)

AMI, acute myocardial infarction; CEO, chief executive officer. Adapted with permission from Bradley, Curry et al., Annals of Internal Medicine, May 1, 2012.