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Table 2 Overview of themes and subthemes

From: Lessons learned from implementing a responsive quality assessment of clinical ethics support

Motivation- learning from each other’s CES practices
- Curiosity
- Strategy
My objective was simply to see how other health care organizations organize CES and to learn something I could really use in my own organization (R8)
Perception of the objective of the assessment- Audit or assessment
- Score list or quality characteristics
- Professionalization
A score list doesn‘t do justice to what happens there in practice (…) Implementation is a word we no longer use here, or unroll, that word is even worse (…). We focus much more on how we can stimulate people, tempt them to start new things (…) By connecting with the things people are intrinsically motivated to do (R6)
Preparation of the assessment- Preparing questions
- Attitude (open or critical)
- Strategy
- Division of work
Within the organization we visited, the CES practitioners decided to be present during all the conversations we had. This was a deliberate choice. While, on the other hand, we deliberately decided not to be present during the entire assessment (R2)
Perceived changes as a result of the quality assessment- New CES methods
- Acknowledgement of CES
- Formalizing CES practices
- Inspiration
- Self-reflection
They had a yearly meeting. But really well designed. On the Internet, and also brochures and the like. With videos, so we would really indulge. Incredibly professional. I thought, goodness, this is fantastic (R7)
Context of CES in the organization- Workload
- Organizational changes
- Place of CES in organization
You can participate in the national training [moral case deliberation] which is very interesting but also very expensive. Well, it would be nice if this could be facilitated as it will result in better skilled employees [CES practitioners] (R6)
NEON as a learning community- Schooling
- Support/ Being part of a national CES community
- Professionalization
And I very specifically would like to get some expertise in the field of healthcare ethics (…) I am thinking about some kind of ethical deliberations (…) a sort of basic training in ethics (R7)
Who is the assessor- Background/ education
- Competences
- Feelings regarding the assessment
I feel quite competent as an assessor. But I do not feel like an ethicist. And, er, that also has to do with the fact that I [silence] have not followed a specific training for it (R7)
Quality of the assessment- Interaction between respondents (as assessors)
- Workload
- CES knowledge/ competencies of the assessor
So yes, there was a conflict, there were conflicting signals. This is confidential isn’t it. It is just a small example. So how you do work with each other there were actually, er, conflicting signals in our interactions (R4)