Page 137 - The Handbook for Quality Management a Complete Guide to Operational Excellence

124 I n t e g r a t e d P l a n n i n g U n d e r s t a n d i n g C u s t o m e r E x p e c t a t i o n s a n d N e e d s 125

normal, busy workday. The interviews took place during Septem-
ber 1993. Interviewers were given the instructions recommended
by Hayes (1992, pp. 14–15) for generating critical incidents.
A total of 36 telephone attempts were made and 23 patients were
reached. Of those reached, three spoke only Spanish. In the case of one
of the Spanish-speaking patients, a family member was interviewed.
Thus, 21 interviews were conducted, which is slightly greater than the
10 to 20 interviews recommended by Hayes (1992, p. 14). The 21 inter-
views produced 93 critical incidents.

Classification of Data The Incident Classification System required by CIT
is a rigorous, carefully designed procedure with the end goal being to
make the data useful to the problem at hand while sacrificing as little
detail as possible (Flanagan, 1954, p. 344). There are three issues in doing
so: (1) identification of a general framework of reference that will account
for all incidents, (2) inductive development of major area and subarea
categories that will be useful in sorting the incidents, and (3) selection of
the most appropriate level of specificity for reporting the data.
The critical incidents were classified as follows:

• Each critical incident was written on a 3 × 5 card, using the patient’s
own words.
• The cards were thoroughly shuffled.
• Ten percent of the cards (10 cards) were selected at random,
removed from the deck and set aside.
• Two of the four team members left the room while the other two
grouped the remaining 83 cards and named the categories.
• The 10 cards originally set aside were placed into the categories
found in step 3.
• Finally, the two members not involved in the initial classification
were told the names of the categories. They then took the reshuffled
93 cards and placed them into the previously determined categories.

The above process produced the following dimensions of critical
incidents:

• Accommodations (5 critical incidents)
• Quality of physician (14 critical incidents)
• Care provided by staff (20 critical incidents)
• Food (26 critical incidents)
• Discharge process (1 critical incident)
• Attitude of staff (16 critical incidents)
• General (11 critical incidents)

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