Using resident focus groups to improve subspecialty consultations in a pediatric urgent care setting.
BACKGROUND
In a pediatric urgent care center, patients requiring management by subspecialty consultants have average waiting times of two hours. Pediatric resident input was sought in order to identify problems and propose urgently needed solutions.


OBJECTIVE
1) To define the dimensions on which residents measure quality of consultations; 2) To generate solutions for perceived problems.


METHODS
Mixed methods, including focus groups, survey questionnaires and an intervention, were used. Focus groups and questionnaires involved pediatric residents from a large public hospital that provides care to medically underserved African-American and Latino patients.


RESULTS
Residents defined four dimensions of quality: waiting time, teaching, courtesy and overall quality of care. An intervention made with the service having the poorest ratings on the questionnaire consisted of a detailed discussion of focus group findings and recommendations. The overall effectiveness of the intervention was evaluated by analyzing pre- and postprogram measures. Postintervention ratings showed significant improvement of ratings along three of the four dimensions of concern.


CONCLUSIONS
At minimal-to-no cost to an institution, focus groups composed of residents can generate viable solutions to observed problems. This form of feedback could be beneficially incorporated into an institution's continuous quality improvement processes.
Singleton
Alice Faye
AF
Department of Pediatrics, Martin Luther King, Jr./Charles R. Drew Medical Center, Los Angeles, CA 90059, USA. alsingle@cdrewu.edu
Bazargan
Mohsen
M
Ilagan
Brenda
B
Yan
Leon
L
Eugenio
Jasmine
J
D001071:Appointments and Schedules; D002983:Clinical Competence; D004632:Emergency Medical Services / Q000458:organization & administration*; D017144:Focus Groups; D006801:Humans; D007396:Internship and Residency; D010372:Pediatrics; D012017:Referral and Consultation; D011795:Surveys and Questionnaires