Table 6 ‘InDepth’ case-level analysis scheme

Onsite debriefings and cross-briefings

Debriefings are conducted following each stage of data collection, during which the involved researchers note main observations and establish a tentative list of predicted barriers, facilitators, and emerging themes. This information is then cross-briefed with the remaining researchers while still on-site.

Microanalysis, theme identification

Following each visit, transcripts are read line-by-line by at least two researchers to identify recurring themes and to suggest relationships among them. These emerging themes are then discussed among all investigators to establish a list of main themes.

Open and axial coding, theme memos

Once the main themes for the site have been established, a process of open and axial coding[46] begins, during which all written data will be revisited and text will be coded in order to identify concepts and dimensions covered in the data. This coding is axial in that it identifies manifestations of each theme and its sub-themes at different levels of the organization, always occurring around the axis of the main theme. This analytical process results in the creation of theme memos, where each statement is supported by corresponding quotes or references to the observation narratives or artifacts and pictures.

Case reports

Once all theme memos are completed, they are discussed among all investigators to determine which themes are the most relevant to our central research questions and may have the most important implications on success or failure of the WP5 intervention. Relational ‘hypotheses’ are formulated about how concepts may relate in order to better understand phenomena taking place in the institution. All of this information is then compiled into a case report.

Intermediate and final reports

The above case-level analysis is completed for each of the six hospitals prior to and following the intervention. By combining these approaches and by using a sensitizing scheme (being aware of existing evidence of barriers and facilitators for diffusion of innovation and implementation in organizations) for the preparation and execution of the inquiry and using a grounded approach (generating theory directly from the material) for the analysis, a multidimensional picture of structural, organizational and interpersonal contexts will emerge as a basis to define local and universal barriers and facilitators for infection control interventions.