Establishing goals and priorities in a surgery department

Limitation of resources necessitates prioritization in the planning of goals for a clinical discipline such as surgery. Private practitioners and academic surgeons have their own priorities which reflect their specific, often conflicting, interests. We describe a model (modification of Davies & Morgan, 1983) for establishing goals and priorities with input from both private practitioners and academic full-time surgeons in a large Department of Surgery. The model consists of four phases each of which is divided into input, process and output stages. During the input stage general large group discussion allows identification of disparate views. This is followed by refinement of these ideas in small group discussions (process) which results in the formulation of a report (output). Application of this model resulted in a clear definition of goals and priorities by consensus and placed education first on this list of priorities in spite of a department in which there is a predominance of private practitioners whose major area of activity is in the realm of patient care.