Table 2

Professional quotes on operating among dynamics in the RMoC implementation experience

Operating among dynamics
The patientsReadiness
‘It’s really focused more in the last little while. We revamped it since attending the HealthChange methodology group session. We changed the focus to be a lot more focused on readiness. Having the client be aware of what the treatment might involve, what the options are with treatment. So they just come a little bit more informed to make an informed decision.’ (Focus Group 4 Participant)
Screening and intake
The process of getting to [this program] is actually quite a long journey. Longer than the actual program itself. So we tried to set up a metric to see if we could reduce that, and try to evaluate that. The end result is that we have in some sort established a more streamline approach to assessing a client so that they have an idea of whether they’re able to make it into class or if their accepted to class or not be accepted to class. And then help them way-find if they’re not.’ (Focus Group 3 Participant)
We want them to be informed and to be ready for the coming to treatment because it’s a really large commitment that we’re asking them to do so we want them to feel like that they’re a part of what we’re offering and that they know what they’re getting into.’ (Focus Group 4 Participant)
The teamManagement
The challenges that I can think of were around the trans-disciplinary model and the challenges around having constant FTE available. So we struggled with [discipline A] and [discipline B] for a number of months because management was saying they were supportive of it, but yet maybe not so … when you’re withdrawing [these disciplines] for periods of day [sic] it really affects the structure and the process that we were trying to build.’ (Focus Group 10 Participant)
Team changes
One of the things that we discussed a lot was team dissemination and how to get everybody else on board with kind of what we were doing. And we decided that because of all the shortages and the excess stress that was on our team at the moment, we were kind of [like] we’ll just keep this to ourselves until we figure out how it works. We had a few tech stumbling blocks and some process things that we were trying to work through. And we were just like maybe we’re not going to just be like ‘here guys have this thing even though it’s not done.’ I think that would have just caused mass pandemonium.’ (Focus Group 6 Participant)
Other colleagues
It [was] really, really difficult to come back from the session and explain it to anybody because really I found it very difficult. … The model is very large and the amount of stuff that we could put into place is huge. And understanding how much of that we were expected to be incorporating into our site that wasn’t clear and like there are so many different aspects and so are we supposed to be doing all of them, are we only supposed to be doing a little bit of it, do we only apply it to the [specific program] group?’ (Focus Group 8 Participant)
The resourcesPerceived efficiency
Moderator: How did you compare the Telehealth Learning Session to the in-person ones?
P1: Much better use of time and money
P2: And it was nice we were all there for that one
P3: Yeah everybody was in the same room, so then we could all have the same discussion afterwards
P2: And hear the same thing.’ (Focus Group 9 Participants)
Learning sessions
(At the Learning Session), I personally think with doing it on our own time, how it would have probably worked better on a smaller scale is to have goals. … It was really too much fluff, too much things. But if you had set it up and said okay I, we’re starting in April so by May/June we need you to have this metric done. You’re like okay and if you need this metric done in June, you have a timeline that you work back to April. … If it was broken down a bit more like that, practical like that, I think it would have been better.’ (Focus Group 2 Participant)
Available resources
So two people. Because we’re such a small department, we really couldn’t have more participants attend these offsite learning collaboratives and kind of participate. … I think originally we tried to have [another discipline] involvement but that didn’t really work out very well. Again caseloads.’ (Focus Group 1 Participant)
  • RMoC, Rehabilitation Model of Care.