Table 4.

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

Theme	Sub-theme 1	Sub-theme 2	Trigger tool	PC-Safe-Quest	PREOS-PC	Prescribing Safety Indicators	Medicines Reconciliation Tool	Concise Safe Systems Checklist for General Practice
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