Table 3.

Contextual motivators based on changes after implementation of the continuous quality improvement program.

Improvements in care	Job descriptions
Clinical knowledge: •“The research improves knowledge of healthcare providers” •“[After] we had staff meetings, we discussed on how to do things […] trauma injuries and their management and the other things are diabetes” Resources: •“[…] easily know which supplies are important and it helps us in the procurement process” •“The materials for ambulance have also increased and REDCap has helped much in arranging these materials” Accountability: •“Someone who filled the file is always there [at the staff meeting] and he has to give every detail” •“[…] we check the fiche [run sheet] and there is information we call the one who has written the fiche and we inform him about the error he has repeated” Data completion: •“[…] before REDCap the staff was dodging the files and they were not filling them well” •“[Before] files were incomplete and there were no proper time during staff meetings to discuss the issue. So, the REDCap helped in improving the way files were filled”	Technological expectations: •“One of the difficulties we have here is the problem of internet network” •“Computer skills are a challenge and some [SAMU staff] are shy” Work hours: •“This takes time to fill and you know you have to carry the patient in the golden hour” •“At the beginning they were thinking that it is losing their time” Work load: •“At the beginning of REDCap […] they were seeing it as extra work but now they are convinced that they do their job, they have to do a file and enter data in the system” •“It was my first time to see how our work is done; […] it opened my eyes; after that report we had a staff meeting and we were asking ourselves, ‘is that really what we do?’“ Professional development: •“Since we had staff meetings [with the CQI], we discussed on how to do things, even informal trainings were done [… like for] trauma injuries and their management and the other things are diabetes” •“There has been some meetings and trainings […] about CPR for instance” Team building: •“We are different staff and maybe with different skills […] but we take time and discuss about them together” •“When we are on the field we try to exchange ideas […] and we may discuss [patient treatment]”

Views on research

Experiences with data

Patient benefits: •“The first persons to benefit from research are the SAMU staff because it adds on some new information and it helps to improve the care they provide” •“The care has improved because of REDCap, because whenever the presentation was saying oxygen is at 40%, we were working to increase the numbers” National pride: •“REDCap helps our health sector especially SAMU” •“When the data from REDCap are there, some policies can be made” Personal curiosity: •“I know well that when I try to do research I will be more helpful to the service and the country in general” •“[…]it's very important to me, the service and researchers because next time […] I want to do something for the hospital, I'll come here [to REDCap]”

Personalization: •“Yes, I think that if everyone gets a login it will help them” Feedback: •“They [staff meetings] were showing us our weaknesses and the next days, we had to improve” •“We meet in the morning staff and we give feedback on the interventions we did overnight and at that time we discuss on what we can change and what to do to REDCap and improve the quality of our action” Meaning of data: •“When someone is giving feedback with evidences, you easily see where there is a gap […] now I can change” •“With research, you get the feedback [data] and know where to focus”