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Table 2 Comparison of the emergent key concepts and number of quotations across different states

From: Perceptions and experiences of emergency department staff during the implementation of the four-hour rule/national emergency access target policy in Australia: a qualitative social dynamic perspective

Theme

Key Concepts

Number and % of respondent for each concept by States

Number and mean number of quotations by States

All states (n=119)

NSW/ACT (n=52)

WA (n=30)

QLD (n=37)

All states

NSW/ACT

WA

QLD

No.

No.

%

No.

%

No.

%

No.

No.

Mean

No.

Mean

No.

Mean

Personal experiences of stress and morale

4HR/NEAT increased stress and decreased morale

109

44

85%

30

100%

35

95%

1146

323

7.3

512

17.1

311

8.9

4HR/NEAT increased workload

81

28

54%

22

73%

31

84%

419

135

4.8

132

6.0

152

4.9

4HR/NEAT improved morale in ED staff

18

7

13%

7

23%

4

11%

52

13

1.9

32

4.6

7

1.8

4HR/NEAT improved the clinical role performance

8

0

-

7

23%

1

3%

11

0

-

9

1.3

2

2.0

4HR/NEAT decreased stress

4

1

2%

2

7%

1

3%

5

1

1.0

2

1.0

2

2.0

Intergroup dynamics

4HR/NEAT necessitated the Whole of Hospital Approach (WoHA)

87

31

60%

28

93%

28

76%

334

120

3.9

124

4.4

90

3.2

4HR/NEAT impaired relationships with rest of the hospital

77

33

63%

21

70%

23

62%

257

86

2.6

84

4.0

87

3.8

Hospital failed to employ the WoHA

54

26

50%

9

30%

19

51%

190

113

4.3

13

1.4

64

3.4

Suboptimal leadership and insufficient buy-in at hospital executive confounded 4HR/NEAT-related changes

47

21

40%

9

30%

17

46%

128

59

2.8

18

2.0

51

3.0

4HR/NEAT undermined ED teams and teamwork

35

13

25%

14

47%

8

22%

82

36

2.8

31

2.2

15

1.9

4HR/NEAT improved relationships with rest of the hospital

33

15

29%

10

33%

8

22%

40

15

1.0

14

1.4

11

1.4

4HR/NEAT improved communications within ED staff

29

11

21%

16

53%

2

5%

50

18

1.6

29

1.8

3

1.5

4HR/NEAT worsened communication within ED staff

26

9

17%

13

43%

4

11%

43

16

1.8

22

1.7

5

1.3

4HR/NEAT improved ED teams and teamwork

25

5

10%

12

40%

8

22%

39

9

1.8

17

1.4

13

1.6

4HR/NEAT signified the importance of hospital’s executive buy-in

21

11

21%

6

20%

4

11%

59

32

2.9

16

2.7

11

2.8

4HR/NEAT increased autonomy of ED staff

16

9

17%

4

13%

3

8%

25

16

1.8

4

1.0

5

1.7

4HR/NEAT shifted the flow of power from ED to hospital executives

6

6

12%

0

-

0

-

7

7

1.2

0

-

0

-

4HR/NEAT led to overwhelming pressure from department of health

4

0

-

2

7%

2

5%

5

0

-

3

1.5

2

1.0

Interaction with patients

4HR/NEAT decreased staff-patient communication

43

12

23%

14

47%

17

46%

140

36

3.0

46

3.3

58

3.4

4HR/NEAT improved staff-patient communication

26

9

17%

6

20%

11

30%

56

15

1.7

23

3.8

18

1.6

4HR/NEAT had no change on staff-patient relationships

17

6

12%

7

23%

4

11%

20

8

1.3

8

1.1

4

1.0

Non-4HR/NEAT factors influencing staff-patient communication

6

2

4%

3

10%

1

3%

6

2

1.0

3

1.0

1

1.0