Table 7.

Explanations for changes in the Task Orientation sub-scale.

	Where Task Orientation score increased (8 sites)	Where Task Orientation score decreased (5 sites)
Thematic statements	Time was devoted to jointly identifying weaknesses and potential improvements (ongoing appraisal and reflection), using feedback from the initiative evaluation Good planning and effective management was used to establish priorities, check tasks and ensure the initiative remained on track Multidisciplinary meetings were well attended and enabled professionals to openly and honestly discuss operational problems and solutions, exchange perspectives and collaborate There was good collaboration between steering group members who developed a trusting relationship, shared perspectives and jointly discussed options and decisions Operational level staff as well as higher managerial staff were present in the steering group, which assisted in the identification of improvements.	The service being improved was publicly subsidised and therefore quite defined/constricted (making it harder to question)