Table 3 Themes and sub-themes likely to explain responses to questions about organisational readiness for change

Acceptability and appropriateness

Impact on practice and education

“Seriously, I think it’s one of the best things that’s happened in a long time for advancing our practice and education.”

Nurse/Midwife D

“. .. the last meeting, it raised a lot of questioning. So and we all think we are all doing the same thing. But the last meeting showed that we don’t really do the same thing.”

Physician C

“Evidence Rounds were very, I think concise. And all the documents were there. I think it gives you a much better overview of of [sic] things. And it certainly has led us to question our practice. And the one thing that jumps to mind was the medication pre-intubation. [. ..] Evidence Rounds are very good at making us all think about our practice. And how we can improve it. Are we doing things safely? Are we in keeping with national and international evidence supported best practice, recommendations?”

Physician E

“I don’t want to use the word ignorance but it definitely educates people into, you know. .. .[trails off]. Again, a flaw of medical practice is the kind of folklore of practice. That people work in one hospital and oh they all did this here and that’s why we’re doing it now. Why aren’t you doing this, because they’re all doing that there? But people often fail to look at what the evidence is to support the treatment or to support the practice.”

Physician D

Comparison with journal club

“journal clubs are good if they’re used the right way. But what happens an awful lot is that people focus on one article. And it may not be the most up to date article. And it’s just one particular aspect. Whereas the Evidence Rounds I find are really good because it’s more like you’re going to all the various repositories, to access your evidence. You’re looking at your Cochrane review and your meta-analysis. You’re getting more of a, I guess, an eagle view of it.”

Physician E

“. .. . journal club tends to just whip out one article. .. . and often it may have a biased view. .. .”

Physician D

“I know we used to have a journal club. .. that went for a while but it didn’t take off.”

Nurse/Midwife C

Promoting interprofessional collaboration across multiple disciplines

“it’s a platform for different groups [to] say, do we agree with it, do we not agree?”

Physician C

“I liked the multidisciplinary approach, I thought that was brilliant. I really and I loved the fact that so many of the midwives even came from the other wards that I wouldn’t know very well. And they participated and asked questions. .. you got a great discussion going.”

Nurse/Midwife E

“I think it’s very, very important here. .. . that it is very much combined obstetrics and neonates [. ..] [midwives] need to be able to speak at meetings and in groups and kind of, because [they] do have such a different perspective. But this has never been encouraged really in the Irish setting.”

Nurse/Midwife G

Pushing and changing slowly

Implementation of evidence

“.. . some things are not needed to go in the guidelines but again it takes time for anything to change. But again I think it doesn’t matter, it’s important to talk about it and to, because things like this are pushing and changing slowly.”

Physician B

“We have changed practice, we can see it already.”

Nurse/Midwife F

“And that’s definitely changed practice because now we are bringing it in [Evidence Rounds session on Timing of umbilical cord clamping] [.. .] And we’re discussing it and we’re aware of it [. ..] And it’s coming on the new neonatal guidelines so that’s going to be, it was great to have that evidence to know whether we wanted it or not [. ..] The progress and the changes will be slow but the awareness is there, it’s just sitting down to actually get the work done.”

Nurse/Midwife E

“I think it gives you idea to, you know, change the practice but it will not straight away. .. . once you. .. have some audit or something because we would change the practice.. . So that Evidence Round will give you a thought and then you can take that point and then you can. .. change the the recommendation and the practice”

Physician A

“we haven’t changed too much.”

Physician E

Writing and updating clinical practice guidelines

“you can’t just change practice after an Evidence Round, it has to be put into a guideline before we can, like we can’t just say oh we’re going to use this drug, that drug and then do it, we actually have to have it in the guidelines.. .. It’s gonna [sic] take time to do the guideline out and you know they have to go to guideline meetings then and then after that, it will be put into practice. So it’s not going to be overnight that the practice will be changed. But it will be eventually.”

Nurse/Midwife C

“people setting the guideline for the hospital are the one who should really attend. Otherwise we would just be speaking about the evidence without applying it to our daily practice.”

Physician F