Clinicians’ Experience of Providing Care: A Rapid Review

Abstract

BackgroundHealth care services internationally are refocussing care delivery towards patient centred, integrated care that utilises effective, efficient and innovative models of care to optimise patient outcomes and system sustainability. Whilst significant efforts have been made to examine and enhance patient experience, to date little has progressed in relation to provider experience. This review aims to explore this knowledge gap by capturing evidence of clinician experience, and how this experience is defined and measured in the context of health system change and innovation.Methods:A rapid review of published and grey literature review was conducted utilising a rapid evidence assessment methodology. 79 studies retrieved from the literature were included in the review. 14 articles were identified from the grey literature search and one article obtained via hand searching. In total, 94 articles were included in the review. This study was commissioned by and co-designed with the New South Wales, Ministry of Health.Results:Clinician experience of delivering health care is inconsistently defined in the literature, with identified articles lacking clarity regarding distinctions between experience, engagement and work-related outcomes such as job satisfaction. Clinician experience was commonly explored using qualitative research that focused on experiences of discrete health care activities or events in which a change was occurring. Such research enabled exploration of complex experiences. In these contexts, clinician experience was captured in terms of self-reported information that clinicians provided about the health care activity or event, their perceptions of its value, the lived impacts they experienced, and the specific behaviours they displayed in relation to the activity or event. Moreover, clinician’s experience has been identified to have a paucity of measurement tools. Conclusion:Literature to date has not examined clinician experience in a holistic sense. In order to achieve the goals identified in relation to value-based care, further work is needed to conceptualise clinician experience and understand the nature of measurement tools required to assess this. In health system application, a broader ‘clinician pulse’ style assessment may be valuable to understand the experience of clinical work on a continuum rather than in the context of episodes of change/care.

Evaluating clinician experience in value-based health care: the development and validation of the Clinician Experience Measure (CEM)

“…8 Western NSW Local Health District, Broken Hill, NSW 2880, Australia. 9 Blacktown and Western Sydney Local Health District, North Parramatta, NSW 2151, Australia. 10 Strategic Reform Branch, NSW Ministry of Health, Sydney, NSW 2065, Australia.…”

“…As key actors in health systems and services, clinicians from all professions have vital roles in promoting health through the planning and delivery of care. Clinicians’ experiences of providing care, including their ability to input into decision-making, of providing the safest possible care, and of being respected and valued by colleagues, have been associated with both better clinician well-being and patient outcomes [ 9 ]. Conversely, detrimental experiences, such as emotional exhaustion due to work pressures, have been associated with poorer clinical outcomes [ 10 ].…”

“…Despite its importance, clinician experience is a poorly defined concept, creating challenges for health systems to embed routine measurement and improvement of clinician experience [ 9 ]. In a review of published and grey literature, we established that no existing measurement instruments assess clinician experiences of providing care that could be applied system-wide [ 9 ]. Several included studies did however report qualitative and survey data about clinicians’ experiences of specific events.…”

“…Several included studies did however report qualitative and survey data about clinicians’ experiences of specific events. From synthesising this evidence, we identified common factors that were central to a clinicians’ experience of providing care and using this evidence, we defined ‘clinician experience’ as clinicians’ perceptions of the quality and safety of care provision, interprofessional collaboration and work environment, their engagement in decision-making and psychological experiences in the workplace [ 9 ]. For health systems to benchmark and assess the success of initiatives to assess and improve clinicians’ experiences, a set of common measures to capture clinicians’ experiences of providing care system-wide is required.…”