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Table 5 Conceptualizations of quality at the micro level

From: Talking about quality: exploring how ‘quality’ is conceptualized in European hospitals and healthcare systems

Data source

Quote

Category

Emerging themes

Nurse, Netherland B

‘We can talk about quality of course, but first of all they must see to it that people don’t have to wait months to be admitted, that the patient understands what we’re going to do, and that all the necessary things are available. That’s what I call quality. Basic things that are often not properly sorted out here and that exasperates me day in, day out’.

PE

 

Doctor Portugal A

‘In terms of clinical effectiveness, initially all patients had to be cured, but as this is impossible in terms of pathology and results, we want the best effectiveness outcome appropriate for the situation’.

CE

 

Midwife Sweden A

‘I think that we more or less work as a team, we are posing question and counter question to each other and it’s not only the doctor that is deciding if we should do this or that, even though we should respect each other’s knowledge and it’s as for the doctor that he or she follows the clinical guideline, as it is for us to follow it’.

 

Shared conceptuali-zation of quality between professional groups

Department midwife Norway A

‘It is obvious that their [managers] mind-set is more related to money, while we think more directly about the patients on a daily basis’.

 

Different quality perspective between managers, healthcare professionals

Midwife Norway B

‘The managers remind us about coding all the time. “Remember to code [codes in IT system related to financial reimbursement], remember to code, remember to code”. That is how we are funded. At almost all our department meetings, an expert is present to show us how to do it and how we can improve our coding. “We lose a lot of money if you don’t do this or if you do that”. They tell us all the time. I am a midwife, I am not an economist. I am not “running a shop”’.

 

Different quality perspective between managers, healthcare professionals

Member of the infection control committee Portugal A

‘Aspects related to the human being as a whole, in general, they are not handled. Human beings are a whole and not just the pneumonia or broken leg that took them to the hospital…it is this idea of the whole that fails in this society we live in and this is also reflected in treatment, which is very technological. We have good equipment, excellent endoscopes, excellent neurosurgeons, we have excellent surgeons, but dealing with that situation. However, the patient is a whole and it’s that part that I think quality needs to worry about, which I think is one of its failings’.

CE

Highly specialized services caused lack of holistic perspective on quality beyond CE

Chief medical doctor palliative team Norway A

‘Time is our luxury, we have enough time, and if we don’t have time we are useless…. The real indicator of our success is the patients’ subjective experience’.

PE

Quality dimensions vary between clinical services