Ziekenhuisgroep Twente, Almelo, The Netherlands.
BMC Health Serv Res. 2010 Apr 1;10:86. doi: 10.1186/1472-6963-10-86.
The demands in hospitals for safety and quality, combined with limitations in financing health care require effective cooperation between physicians and managers. The complex relationship between both groups has been described in literature. We aim to add a perspective to literature, by developing a questionnaire which provides an opportunity to quantitatively report and elaborate on the size and content of differences between physicians and managers. Insight gained from use of the questionnaire might enable us to reflect on these differences and could provide practical tools to improve cooperation between physicians and managers, with an aim to enhance hospital performance.
The CG-Questionnaire was developed by adjusting, pre-testing, and shortening Kralewski's questionnaire, and appeared suitable to measure culture gaps. It was shortened by exploratory factor analysis, using principal-axis factoring extraction with Varimax rotation. The CG-Questionnaire was sent to all physicians and managers within 37 Dutch general hospitals. ANOVA and paired sample T-tests were used to determine significant differences between perceptions of daily work practices based in both professional cultures; culture gaps. The size and content of culture gaps were determined with descriptive statistics.
The total response (27%) consisted of 929 physicians and 310 managers. The Cronbachs alpha's were 0.70 - 0.79. Statistical analyses showed many differences; culture gaps were found in the present situation; they were even larger in the preferred situation. Differences between both groups can be classified into three categories: (1) culture gaps in the present situation and not in the preferred, (2) culture gaps in the preferred situation and not in the present, and (3) culture gaps in both situations.
With data from the CG-Questionnaire it is now possible to measure the size and content of culture gaps between physicians and managers in hospitals. Results gained with the CG-Questionnaire enables hospitals to reflect on these differences. Combining the results, we distinguished three categories of increasing complexity. We linked these three categories to three methods from intergroup literature (enhanced information, contact and ultimately meta cognition) which could help to improve the cooperation between physicians and managers.
医院对安全和质量的要求，加上医疗保健融资的限制，需要医生和管理人员之间进行有效的合作。这两组人员之间的复杂关系在文献中有描述。我们旨在通过开发一种问卷来为文献增添一个视角，该问卷提供了一个机会，可以定量报告和详细说明医生和管理人员之间差异的大小和内容。使用问卷获得的见解可以使我们反思这些差异，并为改善医生和管理人员之间的合作提供实用工具，以提高医院绩效。
CG 问卷是通过调整、预测试和缩短 Kralewski 的问卷开发的，并且似乎适合测量文化差距。它通过使用主轴因子分析，采用 Varimax 旋转进行探索性因子分析进行了缩短。CG 问卷被发送给 37 家荷兰综合医院的所有医生和管理人员。使用方差分析和配对样本 T 检验来确定基于两种专业文化的日常工作实践感知之间的显著差异；文化差距。使用描述性统计来确定文化差距的大小和内容。
总响应率（27%）包括 929 名医生和 310 名管理人员。Cronbach's alpha 值为 0.70-0.79。统计分析显示存在许多差异；在现状中存在文化差距，在偏好情况下的差距更大。两组之间的差异可分为三类：（1）现状中的文化差距而不是偏好，（2）偏好情况下的文化差距而不是现状，以及（3）两种情况下的文化差距。
使用 CG 问卷的数据，现在可以测量医院医生和管理人员之间文化差距的大小和内容。CG 问卷的结果使医院能够反思这些差异。结合结果，我们区分了三种越来越复杂的类别。我们将这三个类别与来自群体间文献的三种方法联系起来（增强信息、接触，最终是元认知），这可以帮助改善医生和管理人员之间的合作。
