Table 6.

Themes and Examples from Clinician Interviews

Sharing the same EHR■ … “made a big difference. One of the biggest challenges is dealing with different EHRs. Knowing that we are all the same that way, because one little change can throw things off, even different sites that are the same clinic may have different SmartSets.”
■ … “made it slightly easier in terms of talking about quality improvement or a workflow, especially trying to facilitate improvements with the EHR, everyone knows how it would work.”
■ “It's nice to share information, but to share monthly meetings with both clinics didn't make any sense because they were so different.”
Belonging to the same practice group■ “I think the fact that we were all from the same company, we all have the same difficulties with our patients. I think that helped us as far as being able to make suggestions to know what the other is going through and roadblocks we encounter.”
■ … “there's a certain level of comfort [among members of the same group], people are more open to share their opinions.”
Key success factorsSharing performance data
■ … “When you look at your own stats, you always think that they are going to be better than they are. And when you don't see it that way, you ask what you can do better.”
■ “We learned that there is a lot more we can do and have to be more attentive,” and “ … always good to see your data, and see how you stand… . hopefully motivation to keep improving.”
■ “When you saw the numbers at the end and compared to the other clinics that was helpful because there is always a little competition I guess, which motivates staff at times.”
Team support
■ “From my site, I was the only one who consistently took the time… . you got to have the key players at the table, but I would think two or three so it feels like a team effort.”
Satisfaction and sustainability■ “First experience, really enjoyed it.”
■ “It was really good. I'll see about signing up for another wave.”
■ “The project itself went well. The only thing now is keeping it going, the list updated, staying on top of CKD.”
■ “Didn't have the tools to keep the changes going long-term. Good for short-term. To affect patient care, needs to be implemented longer-term; don't have the tools to do that. Still don't today.”
Change in knowledge, skills, and attitudes
CKD knowledge and skills■ “I was shocked at how many patients fall into mild CKD, where their creatinine levels were normal, but their GFRs were low.”
■ “Just having it on the problem list with all my patients has really changed my practice.”
■ “We have so many diabetics on metformin, but I didn't make it a priority to check.”
■ “[It] helped keep staff and me more focused on what we're doing… . it helped us develop strategies to incorporate in daily work.”
Priority for improving CKD care■ “It also made me much more confident that I knew what to look for and had some clue about what to do with what I found.”
■ “… definitely made a difference in terms of my priority. I wasn't really clear about the management and treatment and identification of CKD. And this study really put things in focus when we discussed the numbers [feedback reports].”
  • CKD, chronic kidney disease; EHR, electronic health record; GFR, glomerular filtration rate.