Table 2 The different steps of the analysis

Examples of

"That's what you want after all, a bit of guidance so that there's some equality"

Care on equal terms

Reasons

Top-down

"Otherwise you risk being reported for what you do or don't do ... and even if you don't think about it all the time, it's something you know about ... and that means that, besides having a general desire to do good, so to speak, you naturally have it as a reason to try to stay updated and do the right things"

Good care

"We do it mostly because you've got to have something, it's what you're supposed to have according to the National Board of Health and Welfare"

External compulsion

"It has meant that I have been on quality courses and I've sat on the quality group at the County Council, where they worked with Quality, Development, Leadership, which I was dubious about. Far too big and too ... it didn't suit our work in primary care"

Externally imposed control system (package solutions)

Methods

"Well, if we are to return to our own quality assurance system, here are 21 points, this here, our very own system that we sometimes take out to see if we fulfil ... and then we go through it and reflect, have we done this and that, does this work, have we written up, and things like that"

Locally developed control system

"You try all the time to keep updated when it comes to local, national, and international care programmes and the like, we try to work with the medical quality"

Internal demands

Reasons

Bottom-up

"One effect that is maybe not so noticeable, but I myself feel more secure in my own role, and I believe that I pass that on to the patients too: I know this is the best thing for you"

Good and equal care

"You do that all the time ... with the individual patient. Find out, follow up, because I meet each patient all the time"

Own follow-up

Methods

"... we have at least an hour allocated each week when all the colleagues meet and you have a chance to present cases and get comments"

Collegial comparison