Clinicians’ experience of providing care: a rapid review

Abstract

Background Health 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. Seventy-nine studies retrieved from the literature were included in the review. Fourteen 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.

Measuring clinician experience in value-based healthcare initiatives: a 10-item core clinician experience measure

“…[17][18][19][20] Existing instruments have largely explored individual psychological states and traits, well-being and/ or workplace conditions. 3 Similar constructs are regularly explored in workplace surveys among healthcare staff in Australia and internationally. [21][22][23] While value-based care outcomes include clinician's experiences of providing care, the concept of clinician experience in this context has been ill-defined contributing to challenges in measuring and reporting this outcome from VBHC initiatives.…”

“…2 As key actors in health systems and services, clinician's (from all professions) experiences are identified as a key outcome for VBHC initiatives, yet measurement of clinician's experiences of providing care has received limited attention to date. 3 In 2020, a rapid systematic literature review confirmed that the concept of 'clinician experience of providing care' relevant to VBHC was poorly defined with an absence of dedicated measurement tools. 3 The included articles demonstrate that clinician's experiences of providing care are dynamic, influenced by the work context, professional group and patient cohort.…”

“…3 In 2020, a rapid systematic literature review confirmed that the concept of 'clinician experience of providing care' relevant to VBHC was poorly defined with an absence of dedicated measurement tools. 3 The included articles demonstrate that clinician's experiences of providing care are dynamic, influenced by the work context, professional group and patient cohort. Yet the review concluded from 94 articles that there are key common indicators of whether clinician's have a positive or negative experience of providing care.…”

“…These indicators include their ability to input into decision-making, provide safe and high quality care, be respected and valued in interprofessional working and have psychological safety in their workplace. 3 A definition of 'clinician experience' in the context of VBHC was developed drawing from the rapid review. The role of clinician experience within VBHC is described variably in different countries and contexts.…”

The role of champions in the implementation of technology in healthcare services: a systematic mixed studies review

“…The adopting of new technology in healthcare services can be perceived as both an event and a process. According to Iqbal [ 28 ], experience is defined as the knowledge and understanding gained after an event or the process of living through or undergoing an event. This review synthesizes existing empirical knowledge regarding the experiences of occupying the champion role, and the perspectives of health personnel interacting with champions in technology implementation processes.…”