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"My experience is that the greatest obstruction to clinical research is not the patient, it is the other physician…you have to get other physicians on board" (Interviewee 7) To foster commitment among clinicians, there is need to integrate research and clinical work.
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Across the board, our interviewees state that most budgets are inadequate for existing activities, let alone new initiatives.
Nonprofit board member interviewees were not included in the study.
To gain a deeper understanding of the issues, interviewees described board members displaying characteristics that centred on a curiosity to ask questions and be open to critical reflection about 'uncomfortable truths' within the organisation.
In supporting local, as opposed to centralized, boards, almost all interviewees cited advantages of "local knowledge" - e.g., knowing about local subjects.
Yet interviewees across the board saw the absence of dedicated financial resources from national or provincial government as the most significant threat to sustained implementation at scale.
Interviewees across the board saw this training system as poorly aligned to current (let alone future) needs, as expensive, unrealistic (stretching over 4 years) and as failing to secure any meaningful career pathways.
For example, one interviewee spoke of her board's efforts to assure staff "that there's not a blame culture; that reporting is a good thing and it's about improvement" (executive manager, regional).
Figures 1 and 2 show the usual interviewees selected for the Board and Unit interviews respectively.
The 35 interviewees consisted of 7 board chairs, 5 chairs of quality committees, 5 other board members, 7 chief executives and 11 other executive staff (chiefly, medical directors, risk managers and quality managers).
The vast majority of interviewees perceived boards as having both a responsibility and an array of opportunities to oversee and support improvements in the care delivered by their health service.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com