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Table 4 Themes and sub-themes

From: Process evaluation of an implementation trial to improve the triage, treatment and transfer of stroke patients in emergency departments (T3 trial): a qualitative study

Themes and sub-themes Normalisation process theory concept
Readiness to change
Mobilising teams
Authority to implement
Cognitive participation and collective action: Perceived authority of nurse clinical champions to drive change resulted in challenges in achieving collective engagement.
Fidelity to protocols
Engaging with the evidence
Adherence versus adaptation
Coherence: Beliefs about the evidence underpinning the protocols impeded the development of a shared understanding about the applicability of aspects of the protocols in the ED
Boundaries of care
Defining professional boundaries
Care trajectory
Reflexive monitoring: The extent to which the protocols were implemented was influenced by perceptions of clinical roles and responsibilities throughout the patient trajectory.