From: Between and within-site variation in qualitative implementation research
Redundant concept | Convergence or divergence | Supporting data |
---|---|---|
PC/MHI has improved access | Convergence | MHL: Co-location and the size of the clinic promote positive interactions, as providers see each other at lunch and at meetings. |
Convergence | MHL: PC/MHI goal is immediate access; PCMH is always available. | |
Convergence | PCMH: Conducting a pilot study to provide access to walk-in patients. | |
Divergence | PCMH: Getting buy-in from PC is biggest challenge; informal discussions in the lunch room and “selling ourselves” increased curbside consults. | |
Divergence | PCP: Psychiatrists resisted helping PC manage behavioral aspects of chronic diseases, but negotiations have resulted in progress. | |
Referrals include standard referrals and curbside consults | Divergence | PCMH: Nurse routine screening often initiates referrals and some nurses refer patients inappropriately; working with nurse manager to educate staff. |
Convergence | PCP: Norms indicate that knocking on doors is appropriate, even if it interrupts ongoing psychological care. |