Table 1
Type of hospital from which hospital-wide educational committees (HECs) originated and formal positions of participants
|
Type of hospitala and geographical regionb |
Formal positions of participants (P) |
|---|---|
|
HEC1: top clinical teaching hospital, region A |
P 1: Coordinating staff for PGME |
|
P 2: Advisor to the HEC | |
|
P 3: Chair of the HEC | |
|
P 4: Educational supporting staff | |
|
P 5: Formal educator at the department | |
|
HEC2: general teaching hospital, region B |
P 6: Formal educator at the department |
|
P 7: Formal educator at the department | |
|
P 8: Vice formal educator at the departments | |
|
P 9: Advisor to the HEC | |
|
P 10: Successive chair of the HEC | |
|
HEC3: top clinical teaching hospital, region C |
P 11: Vice chair of the HEC |
|
P 12: Resident representative | |
|
P 13: Educational supporting staff | |
|
P 14: Hospital board member and formal educator at the department | |
|
HEC4: top clinical teaching hospital, region D |
P 15: Chair of the HEC |
|
P 16: Formal educator at the department and successive chair of the HEC | |
|
P 17: Coordinating staff for PGME and formal educator at the department | |
|
P 18: Secretary staff | |
|
HEC5: academic teaching hospital, region B |
P 19: Coordinating staff for PGME |
|
P 20: Resident representative | |
|
P 21: Vice chair of the HEC | |
|
P 22: Formal educator at the department | |
|
HEC6: general teaching hospital, region C |
P 23: Educational supporting staff |
|
P 24: Coordinating staff for PGME | |
|
P 25: Secretary staff | |
|
HEC7: top clinical teaching hospital, region E |
P 26: Vice formal educator at the department |
|
P 27: Resident representative | |
|
P 28: Formal educator at the department | |
|
P 29: Chair of the HEC and formal educator at the department |
aAcademic hospital (coordinating PGME for affiliated hospitals); top clinical hospital (providing specialized clinical care, scientific research and PGME); general hospital (providing patient care and PGME)
bCovered a total of 5 out of 8 geographical regions
Table 2
Focus group guide used during the study
|
Number: |
End: |
Transcription: |
|
Date: |
Moderator |
Setting: |
|
Start: |
Observer |
No. participants: |
|
Five main questions |
Topic lista | |
|
What is internal quality management and what is the role of the HEC herein? |
Definition: – Quality assurance (PDCA cycle, performance measurements, performance evaluation, questionnaires) – Quality improvement (action, innovation, consolidation) – Internal auditing | |
|
Internal quality management versus external quality management | ||
|
Parties involved: – Hospital board – HEC – Educationalists/advisors/supporting staff – Departments/teaching teams/clinical teachers – Residents – External coaches/parties | ||
|
Role of HEC: – Promote/stimulate/intervene/execute – Birds-eye view/monitoring – Policy making – Take responsibility/facilitate meetings | ||
|
How do you feel about internal quality management? |
Positive: – Good/important/enthusiastic/activating – Added value (improves quality of residency training) – Supportive to external quality management | |
|
Negative: – Bad/takes time/necessity – Too much work/not useful – Hierarchical | ||
|
What are achievements of internal quality management and the HEC’s effort? |
Levels of impact: – Level of teaching hospital (hospital board, finances, HEC) – Level of departments (leadership, teaching teams, clinical teachers) – Level of residents (more residents, better residents, satisfaction) – Level of the patient (change in care) | |
|
Achievements: – More awareness/attention/interest – Impact of HEC (meetings, content, collaborations, facilities, power, finance) – Education (better programs, development, innovations) – Patient care | ||
|
What is needed to make internal quality management work? What impairs? |
Needed: – Culture (collective vision, everybody on board, representatives, exchange of best practices) – Systems (routines) – Communication/collaboration/support – HEC power (right to intervene, freedom, trust) | |
|
Impairing: – External pressure – Excess work – Compulsivity/coercion/pressure – Pressure to perform more patient care – Lack of finance/support – Content of some tools used in internal quality management | ||
|
Are there remaining topics that were not discussed? What is your take home message? |
– Innovations – Hospital merges – Large scale projects (building, expanding hospital) – Accreditation | |
aThe topic list was used only after initial discussion of the main question. In line with the iterative approach adopted in the study, the topic list was adjusted (mainly extended) for each new focus group, based on topics addressed in previous focus groups. The topic list was used to introduce points for discussion that were not mentioned during initial discussion (to broaden the focus group discussion)