Table 2

Factors affecting medical engagement with the Safer Patients Initiative

BarriersFactors affecting medical engagementEnablers
Programme implemented or viewed as a temporary project1. Quality improvement track recordDoctors previously tried to change practices
Initiative overkillProgramme implemented or viewed as a continuous improvement process
Doctors' work commitments preventing time to be spent on programme-related work2. Resource allocationTime is allocated to programme work
Programme work perceived by doctors to be more or extra work
Doctors' perception that there is not enough time
Doctors' perception of blame apportioned by programme3. Perceptions of the purpose of SPIDoctors' perceptions of genuine purpose of Safer Patients Initiative to improve safety of care
Doctors' belief of responsibility to stick with their best practices
Usually not carried out by medical staff
Poor communication of purpose of Safer Patients Initiative
Lack of scientific evidence on programme components4. Evidence of efficacyDemonstration of Institute for Healthcare Improvement gathered information
Previous medical trainingDemonstration of local evidence
Local feedback
None reported5. External expertiseExternal experts (Institute for Healthcare Improvement) providing ‘credibility’
Poor relationship/rapport between champions and doctors6. Local programme championsGood relationship/rapport between champions and doctors
Not involving doctors champions from the start of the programmeSenior medical champions leading by example
Involving doctors champions from the start of the programme
None reported7. Managerial involvementInvolving managers to increase doctor engagement
Good relationship between Management and doctors