Table 4.
Quotes illustrating the influence of moderators on implementation of OHL-interventions in Irish and Dutch healthcare settings.
| Moderators | Illustrative Quotes from Study Respondents |
|---|---|
| Stage 1 Recruitment | “Ehm what applies to us is that it is filled in by very different people, from very different functions. And that you just do not have the opportunity in your daily work to get these people together in this way about one and the same subject”. (NLD 1 setting 2, participant 5, interview) |
| Facilitation strategies | “… and if you want you can get everything from there (from the internet) and implement it yourself but in practice it is much more awkward. Of course, it often does not work that way. And that is purely because you need a coordinator, and sometimes you will need an authority that is qualified, shall we say. Ehm that guides you or assigns the right people”. (NLD setting 3, participant 12, interview). |
| Intervention complexity | “Well, my experience is that it is a lot. That I, well yeah, that it would be nicer if it [the tool] were digitally better available. And those questionnaires were more simplified and a final results tool was added so that you could process your results more easily”. (NLD setting 3, participant 13, interview) |
| Participant responsiveness | “I think it’s been very useful, great to focus our attention on health literacy even though we knew there was work needed to be done about it. I suppose it kind of focused us and gave us a bit of momentum to get working on it. It was very practical and very clear. Everybody is very interested in it”. (IRL 2, setting 1, participant 21, interview) |
| Stage 2 and 3 Quality of delivery | “Of course we have the results from the Quickscan. And if you approach that very narrowly, you look very closely at the three leaflets we have scanned and the two letters and the oral checklists […]. But the effect of applying the Quickscan is that we simply see what is actually needed. We see that many things are going well, but that there are also points for improvement in this area. In fact, we want to embed that within the center”. (NLD, setting 2, participant 1, interview) |
| Contextual moderators: | |
| (1) Different organisational structures and procedures | “We are a centre but we have different departments. All different departments have different methods. So when we say this must be done differently, that could affect all kinds of different working systems. […] Sometimes it is bound to a computer system that we use”. (NLD, setting 2, participant 1, interview) |
| (2) Limited resources | “So this area of stuff is seen to be like that, it will cost money and it’s letting the dust settle, letting the sun dawn on that last chapter and that we can go at it again but it really has put projects like this, stopped them in their tracks. But I think if it’s done on a phased basis where it’s broken up into smaller mini projects I think it has a lot better chance of seeing the light of day again”. (IRL, setting 1, participant 18, interview) |
| (3) Embedding OHL-interventions into ongoing activities | “See where you can reinforce each other in this area. If you are going to do something as a stand-alone project, it can be done of course, but I think that has less chance of success. I think it is nice that you link it to, there is of course a lot of attention for self-management, of course, and it links to patient-centeredness. Hospitality, so it links to so many parts. And whatever you link it to; it will give you more opportunities to implement”. (NLD, setting 2, participant 1, follow up interview) |
| (4) Obtaining leadership support | “It’s very good! The general manager, the director of nursing, they are very ehm, you know, they are committed to this. They really are! Ehm, they feel it’s very worthwhile and like that it’s ehm, it’s a patient experience initiative as well”. (IRL, setting 1, participant 23, follow up interview) |
1 The Netherlands is abbreviated as NLD. 2 Ireland is abbreviated as IRL.