5 Category 5

Category 5: SPPC I implementing sites, including local leadership and front-line providers

Individual/Site Specific Characteristics

1. Please identify your organization, as well as your role, position, and credentials

2. In what capacity were you involved with the implementation of SPPC in your hospital?

e.g. team member, team lead, physician, data support staff, etc.

1. Intervention characteristics

   1. Evidence strength & quality

      1. What kind of information or evidence were you given that showed whether or not SPPC would work in your setting?

         • How did this knowledge affect your perception of the intervention?

   2. Relative advantage

      1. How did SPPC compare to other programs to improve maternal outcomes in your hospital/unit

         • What were its advantages compared to other programs?

         • What were its challenges compared to other programs?

   3. Adaptability

      1. Do you think any changes or alterations to the SPPC program might have made it more effective in your setting?

         • How easy do you think it would have been to make those changes? Could you have done them yourself?

      2. Were there any components of SPPC that should not be altered? Which ones?

   4. Design quality and packaging

      1. What was your perception of the quality of the supporting materials, packaging, and bundling of the SPPC intervention? Why?

      2. What supports, such as online resources, marketing materials, or a toolkit, were made available to help you implement the SPPC intervention?

2. Outer Setting

   1. Peer pressure

      1. Can you tell me what you know about any other organizations that were part of the SPPC program?

         • Did this information influence the decision to participate in SPPC at your hospital?

   2. External Policies & incentives

      1. Were there any regulatory, financial, or other incentives that influenced your hospital/unit decision to participate in SPPC?

3. Inner Setting

   1. Structural characteristics

      1. How did the infrastructure of your organization affect the implementation of SPPC?

         • How did they facilitate/hinder implementation?

      2. What kinds of infrastructure changes might have helped to better accommodate SPPC?

   2. Networks and communications

      1. How was the working relationship of the SPPC team with leaders? With each other?

      2. Were meetings regarding SPPC program held regularly?

         • Who typically attended? How often were they held?

      3. How did you typically find out about new information in your hospital/unit, such as new initiatives, accomplishments, issues, new staff, staff departures?

   3. Culture

      1. How do you think your organization's culture affected implementation of SPPC?

         • Can you describe an example that highlights this?

   4. Implementation climate

      1. What was the general level of receptivity in your organization to implementing SPPC? Why?

      2. How do people feel about current programs/practices/process that are available to improve maternal outcomes?

         • To what extent do current programs fail to meet existing needs? Did SPPC meet those needs?

   5. Relative Priority

      1. How did the priority of implementing SPPC compare to other priorities in your hospital/unit? How about in your own work?

   6. Organizational Incentives and Rewards

      1. What kinds of incentives were there to help ensure that the implementation of SPPC was successful?

   7. Readiness for implementation

      1. Leadership engagement

         • Was there an SPPC program champion within your organization?

           1. [If Yes] What was/is their role within the organization?

         • What level of endorsement or support did you see or hear from leaders at your hospital regarding the SPPC program?

           1. Who were these leaders and how do you think this affected implementation and adoption of the program?

      2. Available resources

         • Did you have sufficient resources to implement and administer the SPPC intervention?

           1. What resources did you receive or use?

           2. What resources were not available?

      3. Access to knowledge and information

         • What kind of training did you receive regarding SPPC? Others in your hospital/unit?

           1. Did you feel the trainings were adequate to prepare you to carry out your expected roles and responsibilities?

           2. What could have been improved?

4. Characteristics of Individuals

   1. Knowledge and beliefs about the intervention

      1. Do you think the SPPC intervention was effective in your setting?

         • Why or why not?

      2. How did you feel about the SPPC intervention being used in your setting?

5. Process

   1. Planning

      1. What was the plan to implement SPPC? Was it communicated to you or others in your unit?

      2. Did you create a dedicated multi-disciplinary team of providers to lead implementation of SPPC and cultivate buy-in across your unit?

   2. Executing

      1. Was the SPPC intervention implemented according to plan? Why or why not?

   3. Reflecting and Evaluating

      1. Did you receive feedback reports about the SPPC program while it was happening?

         • [If yes] What sort of feedback? How did you make use of it?

         • What would have made it better?

      2. To what extent did your organization/unit set goals for implementing SPPC?

         • What were the goals? How and to whom were they communicated?