title: Staff perceptions of a Productive Community Services implementation: A qualitative interview study.
abstract: BACKGROUND
  The Productive Series is a collection of change programmes designed by the English National Health Service (NHS) Institute for Innovation and Improvement to help frontline healthcare staff improve quality and reduce wasted time, so that this time can be reinvested into time spent with patients. The programmes have been implemented in at least 14 countries around the world. This study examines an implementation of the Productive Community Services programme that took place in a Community healthcare organisation in England from July 2010 to March 2012.
  
  
  OBJECTIVE
  To explore staff members' perceptions of a Productive Community Services implementation.
  
  
  METHODS
  Cross-sectional interview.
  
  
  METHODS
  Community Healthcare Organisation in East Anglia, England.
  
  
  METHODS
  45 participants were recruited using purposive, snowballing and opportunistic sampling methods to represent five main types of staff group in the organisation; clinical team members, administrative team members, service managers/team leaders, senior managers and software support staff. Team members were recruited on the basis that they had submitted data for at least one Productive Community Services module.
  
  
  METHODS
  Semi-structured individual and group interviews were carried out after the programme concluded and analysed using thematic analysis.
  
  
  RESULTS
  This report focuses on six of the themes identified. The analysis found that communication was not always effective, and there was a lack of awareness, knowledge and understanding of the programme. Many staff did not find the Productive Community Services work relevant, and although certain improvements were sustained, suboptimal practices crept back. Although negative outcomes were reported, such as the programme taking time away from patients initially, many benefits were described including improved stock control and work environments, and better use of the Electronic Patient Record system.
  
  
  CONCLUSIONS
  One of the themes identified highlighted the positive perceptions of the programme, however a focus on five other themes indicate that important aspects of the implementation could have been improved. The innovation and implementation literature already addresses the issues identified, which suggests a gap between theory and practice for implementation teams. A lack of perceived relevance also suggests that similar programmes need to be made more easily adaptable for the varied specialisms found in Community Services. Further research on Productive Community Services implementations and knowledge transfer is required, and publication of studies focusing on the less positive aspects of implementations may accelerate this process.
authors.affiliation: University of Essex, Wivenhoe Park, Colchester, Essex, United Kingdom. Electronic address: dkfwil@essex.ac.uk.
authors.forename: Dominique Kim Frances
authors.initials: DK
authors.lastname: Bradley
authors.affiliation: University of Essex, Wivenhoe Park, Colchester, Essex, United Kingdom. Electronic address: mgriffin@essex.ac.uk.
authors.forename: Murray
authors.initials: M
authors.lastname: Griffin
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D004526:Efficiency; D004739:England; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D013222:State Medicine
keywords: Innovation; Productive Community Services; Releasing Time to Care; Thematic analysis