1. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 1 An Approach for Quality Improvement: Self-Rated Problems of Residents Dr. Zekeriya Aktürk, Dr. Nezih Dagdeviren Trakya University Faculty of Medicine, Department of Family Medicine, Turkey

2. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 2 Quality: to meet the expectations!

3. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 3 Background Quality Improvement is Popular Expectations have Increased –Production standards –Patient satisfaction –Performance criteria –... What about the expectations of residents ?

4. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 4 Aim to explore the perceived problems of residents to introduce an approach in the improvement of resident satisfaction

5. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 5 Method Open-ended question: “Please write all problems you perceive as important regarding your educational atmosphere, human relations, health facilities and learning opportunities, including the social and physical conditions”

6. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 6 Sample All 231 residents of Trakya University Medical Faculty Participation rate: %55.8 (129 residents) Our residents are always busy 

7. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 7 Data Retrieval All participants answered the question in a comfortable atmosphere The questionnaires were returned directly and anonymously to the researchers

8. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 8 Data Processing Three researchers examined all responses and established a problem pool consisting of 103 problems by a tally stick method Problem 1 Problem 2

9. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 9 Problem Pool Similar problems were collected under the same heading. Eight problems were excluded (they already had been solved by the quality improvement activities, which just had been conducted at the emergency department)

10. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 10 Grading of the Problems As the second phase of the study, a questionnaire with a five-point Likert scale (0- certainly disagree, 4- certainly agree) containing the 95 problems was distributed to all residents. 01234 Participation to congresses should be supported...

11. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 11 The Next Step Residents were asked to self-complete the questionnaire at an anonymous atmosphere and return to the researchers. 149 residents (64.5%) accepted to join the second phase of the study. The problems were arranged according to the priority calculated via above-mentioned Likert scale scores.

12. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 12 Results Top ten problems –related with education: 6 –related with economical problems :2 –other problems: 2 Individual mean scores for each problem –67 problems (70.5 %) were rated 3 or higher, –25 problems (26.3 %) had a mean score of  2 (agree), –3 problems (3.2%) had mean scores of less than 2.

13. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 13 The results have been distributed to the faculty staff for information and possible improving activities.

14. / 14An Approach for Quality Improvement: Self-Rated Problems of Residents EQuiP Meeting, Heidelberg, 2003 14 Conclusion We suggest this method as a way to determine the problems of residents according to their own perceptions. The results will aid as guides for managers for the improvement of total quality. The same process should be repeated at regular intervals in order to demonstrate possible improvements and to achieve quality improvement.