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. 2020 Mar 18;4(1):bjgpopen20X101019. doi: 10.3399/bjgpopen20X101019
Coherence(sense-making work) Cognitive participation(relationship work) Collective action(enacting work) Reflexive monitoring(appraising work)
Differentiation Enrolment Interactional workability Reconfiguration
 Defining, dividing up, and categorising task:
  •  What do participants think of the concept ’frailty care’ and their experiences delivering it?

  •  What do participants think about frailty and its relevance to their work?

 Recruiting the self and others to tasks:
  •  Do participants believe they are the correct people to drive the implementation forward?

  •  Do participants engage with other staff within or across organisations to implement the frailty policy?

  •  Who initiates the engagement?

  •  Who does and who does not ‘buy-in’ to implement the frailty policy?

 Doing tasks, and making outcomes, in practice:
  •  How is the term ‘frailty’ discussed in consultations?

  •  How do the new requirements affect discussions between patients and professionals?

  •  Does implementing the frailty concept make it easier or harder to identify the patient?

 Changing tasks:
  •  Has identifying frailty been adapted based on experience? If so, how?

Individual specification Initiation Relational integration Individual appraisal
 Making sense of personal versions of tasks:
  •  Are the requirements in the new contract easy to implement?

  •  Do participants understand what tasks/practice require of them?

  •  Do the new requirements bring any benefits?

 Organising an individual contribution to tasks:
  •  Who actively engages to plan/prepare working with a new contract?

  •  Are participants prepared to work with a new contract?

  •  Are individuals prepared to invest time, energy, and work into a particular practice? If so, what is this work?

 Making and communicating reliable knowledge about tasks:
  •  How do the new requirements (such as, identifying frailty) affect trust and confidence between patients and professionals, or between different groups of professionals?

  •  How do professionals work to enact new contracts and maintain relationships?

 Individual evaluation of contributions and tasks:
  •  Is it clear what effects a particular practice (such as, identifying frailty) has had?

  •  Do individuals make efforts to reflect on/appraise work around frailty? If so, how?

  •  Has appraisal work informed whether a particular practice around frailty is advantageous for patients and staff?

Communal specification Activation Skill set workability Communal appraisal
 Making sense of shared versions of tasks:
  •  Who does/does not think implementing a frailty concept is a good idea?

  •  Are the benefits of a particular practice/task (such as, identifying frailty) valued by all participants?

  •  Does a particular task fit with the overall goals and activity of the practice?

 Organising a shared contribution to tasks:
  •  Whether the participants can undertake their roles and tasks, whether any barriers and facilitators are encountered to delivering care for patients with frailty based on the contract

  •  How does a particular task/practice (such as, identifying frailty) feature in practice meetings?

  •  Does the practice team undertake work to arrange a shared contribution to implement frailty policy? If so, what is this work?

 Allocating tasks and performances:
  •  What impact does the introduction of the new contract have on responsibility?

  •  How is a particular frailty requirement distributed within the practice team?

  •  Is the work being devolved to others? If so, how and for what reason?

  •  Does the introduction of identifying frailty alter the awareness of the work done by other members within a practice team?

 Shared evaluation of contributions and tasks:
  •  Do participants contribute or share feedback about a particular practice (such as, identifying frailty) with others? If so, what is discussed?

  •  Has appraisal work informed whether a particular practice of frailty policy is advantageous for patients and staff?

Internalisation Legitimation Contextual integration Systematisation
 Learning how to do tasks in context:
  •  Has there been an understanding of how to implement the new requirement?

  •  Does the staff have time to learn to understand and carry out the new policy?

 Making tasks the right thing to do:
  •  Do the participants believe it is appropriate for them to be involved in the new contract/requirements?

 Supporting and resourcing tasks in their social context:
  •  How is the new contract linked to organisational structure (such as, practice meetings and using guidance)?

  •  Do the participants support frailty policy in all important ways? Are they capable of implementing the new contract?

  •  How is a particular task (such as, identifying frailty) resourced?

 Organising a reliable stock of knowledge about tasks:
  •  Has the organisation developed ways of keeping up to date with approaches to managing a set of practices (such as, the management of frailty)?