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Table 4 Themes and sub-themes

From: Oilcloth sessions as an implementation strategy: a qualitative study in Denmark

31 Sub-themes

Themes

Biggs and Tang’s (2011)

Preparation

 Oilcloth as a method was unknown

Preparing individually and collectively

Teaching method

 Material was sent out to the participants before participation by

 The fact that some participants were involved early in the process (10 years ago) has given them a form of preparation that requires that they are not surprised despite the fact that physical spaces have not been as agreed at that time

 Management and preparation are central to a positive experience with oilcloth sessions

 Management representatives are role models and should appear aligned before participating in oilcloth sessions

 Separation between the organizational and the clinical is not perceived constructively (possible)

Conflicting objectives

Objectives

 The oilcloth method develops over time (becomes more and more standardized); *strengthens* so that objectives, and purposes become clearer

 Due to the “liquid nature” of oilcloth sessions (experience by participants), a similar and clear objective is required

 Experienced prestige/recognition of being selected by its manager

Involving suitable participants

The participants prerequisites

 The target group and the right participants for the new ED (becomes unclear as there is  a dual objective with oilcloth sessions; consensus among the managers (management decisions about organization) but professionally close to the practice (the clinics when they are with the patients)

 Relationship between management, habitual ways of acting and the right participants

 Oilcloth made it clear that nursing is not the object of the oilcloth sessions

Selecting suitable clinical cases

Content

 The case was copied from the medical record, which became an indicator that it was the medical issue that was in focus at oilcloth sessions

 The case should have been more complex

 Oilcloth sessions were controlled by the physicians

Conducting

 LEGO man a mediating artefact

Using suitable materials

Media

 Whiteboard for challenges as a mediating artefact

 The presence of the board of directors was evaluated positively but assumptions were made as to why they were participating [their purpose in participating could have been clarified]

Facilitation the sessions

Teaching method

 The presence of the management symbolized that oilcloth sessions are important

 The participants made assumptions about what the board of directors will learn

 Oilcloth sessions became an explicit experience more than practical training

Temporal structures

Teaching method

 The introduction went too fast when the participants were new to the oilcloth sessions

 New participants lost track along the way. A visit to the new physical buildings would have provided a different insight

 Time and delay for moving into the new ED

 Time for appointments to be in place

Evaluation

 Experiences about trust/mistrust of the implementation of the new ED depending on management and preparation in the oilcloth sessions

Follow-up on the sessions

Assessment

 Missing plan for follow-up (consequence of an experience that oilcloth sessions are a detached and sporadic activity). The consequence can be uncertainty about the new ED

 Uncertainty about follow-up and responsibilities

 Experiences with previous collaborations in daily practice affect the experience of oilcloth sessions [positive and negative experiences]

Adapting to the context

Assessment and organizational context

 Oilcloth sessions can be experienced as a game but also as a strategy for implementing the future

 Waste of public funds