“We could have used a lot more of this before…”: A qualitative study understanding barriers and facilitators to implementing a provincial PPE safety coach program during the COVID-19 pandemic

Abstract

A Provincial PPE Safety Coach Program was introduced to support appropriate use of personal protective equipment by health care workers. The objective was to understand barriers and facilitators to implementation. A qualitative study was conducted mid-2021. Participants were recruited using a purposive sampling strategy. Interviews were conducted using a guide informed by the Theoretical Domains Framework and Consolidated Framework for Implementation Research. Analysis was conducted using the Theoretical Domains Framework. Prominent domains identified by staff were "social influences and skills", "environmental context and resources", "social/professional role and identity", "emotion", and "belief of consequences". Prominent domains identified by safety coaches were "knowledge", "social/professional role and identity", "environmental context and resources", and "memory". Only "environmental context and resources" and "social/professional role and identity" were similar. The main facilitators were fear of COVID-19 and leadership commitment, while the main barriers were lack of clarity and balancing the role. Understanding the local context of a health care environment influenced the success of safety coaches. The role allowed individuals to develop leadership skills and help staff improve their perceived competence in using personal protective equipment. Safety coaches were well received. Influencing factors provide a basis for strategies to embed this approach throughout a health care system.