title: Quality care, public perception and quick-fix service management: a Delphi study on stressors of hospital doctors in Ireland.
abstract: OBJECTIVE
  To identify and rank the most significant workplace stressors to which consultants and trainees are exposed within the publicly funded health sector in Ireland.
  
  
  METHODS
  Following a preliminary semistructured telephone interview, a Delphi technique with 3 rounds of reiterative questionnaires was used to obtain consensus. Conducted in Spring 2014, doctors were purposively selected by their college faculty or specialty training body.
  
  
  METHODS
  Consultants and higher specialist trainees who were engaged at a collegiate level with their faculty or professional training body. All were employed in the Irish publicly funded health sector by the Health Services Executive.
  
  
  METHODS
  49 doctors: 30 consultants (13 male, 17 female) and 19 trainees (7 male, 12 female). Consultants and trainees were from a wide range of hospital specialties including anaesthetics, radiology and psychiatry.
  
  
  RESULTS
  Consultants are most concerned with the quality of healthcare management and its impact on service. They are also concerned about the quality of care they provide. They feel undervalued within the negative sociocultural environment that they work. Trainees also feel undervalued with an uncertain future and they also perceive their sociocultural environment as negative. They echo concerns regarding the quality of care they provide. They struggle with the interface between career demands and personal life.
  
  
  CONCLUSIONS
  This Delphi study sought to explore the working life of doctors in Irish hospitals at a time when resources are scarce. It identified both common and distinct concerns regarding sources of stress for 2 groups of doctors. Its identification of key stressors should guide managers and clinicians towards solutions for improving the quality of patient care and the health of care providers.
authors.affiliation: Research Department, Royal College of Physicians of Ireland, Dublin 2, Ireland Occupational Health Department, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: Blanaid
authors.initials: B
authors.lastname: Hayes
authors.affiliation: Medmark Occupational Healthcare, Cork, Ireland.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Fitzgerald
authors.affiliation: Division of Population and Health Sciences, Department of Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
authors.forename: Sally
authors.initials: S
authors.lastname: Doherty
authors.affiliation: Research Department, Royal College of Physicians of Ireland, Dublin 2, Ireland.
authors.forename: Gillian
authors.initials: G
authors.lastname: Walsh
mesh_terms: D001291:Attitude of Health Personnel; D003253:Consultants / Q000523:psychology*; D003697:Delphi Technique; D005260:Female; D006761:Hospitals; D006801:Humans; D007407:Interviews as Topic; D007494:Ireland; D008297:Male; D010346:Patient Care Management / Q000592:standards; D010820:Physicians / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011787:Quality of Health Care / Q000592:standards; D013315:Stress, Psychological; D017132:Workplace / Q000523:psychology*
keywords: Delphi technique; physician; quality of healthcare; stress; work