Table 3

Description of themes and subthemes on performance experiences of higher-performing and lower-performing facilities

Themes	Subthemes	Description
Preintervention context		Facility’s preintervention context.
	Facility characteristics	Preintervention physical infrastructure as described by providers.
	Team orientation	Preintervention perceived team relationships.
	Learning orientation	Preintervention perceived organisational learning strategies, extent of experimentation and willingness to learn from others.
Engagement with SS2020 intervention		Engagement and learning from the SS2020 intervention.
	Leadership and SSC training	Postintervention perceived learnings from the leadership training intervention, particularly in the implementation of the SSC.
	Capacity building interventions	Postintervention perceived learnings from the capacity building interventions.
	Sustainable learning interventions	Postintervention perceived learnings from the sustainable learning interventions.
Teamwork and communication		Postintervention team relationships, mutual support between team members and extent of open communication.
	Provider buy-in	Postintervention involvement and participation of providers in the SS2020 intervention.
	Hierarchy and open communication	Postintervention extent of imbibed hierarchies including perceived comfort of junior team members in expressing opinions to seniors.
	Collective responsibility	Extent of collective ownership of SS2020, including sharing of responsibilities with non-surgeon providers in surgical teams.
Collective learning		Postintervention group learning, including the balance of individual learning aspirations against team learning goals, translation of knowledge to colleagues, use of data as a learning tool, extent of learning together as teams and evaluation.
	Knowledge translation	Postintervention sharing of knowledge by SS2020 training attendees with colleagues who did not attend trainings and new recruits.
	Data and monitoring	Postintervention perceived need for and nature of use of data for learning, monitoring and decision-making.
	Team learning	Postintervention extent of mutual support and collaboration in intervention tasks to achieve common goals.
Role of leadership		Postintervention leadership engagement with SS2020 and staff expectations about leadership support for intervention functions.
	Expectations from leadership	Postintervention staff expectations about leader’s involvement.
	Leadership engagement	Postintervention leader’s engagement with SS2020.
Perceived impact and beyond SS2020		Postintervention perceived impact of SS2020 and suggestions for improvement.

SS2020, Safe Surgery 2020; SSC, Surgical Safety Checklist.