Hospital Physician Engagement

Abstract

Background: Literature on health system transformation highlights the importance of physician engagement, suggesting that it is a critical factor for lowering costs while improving efficiency, quality of care, patient safety, physician satisfaction and retention. “Engagement” in health care is often defined as a positive, fulfilling work-related state of mind, which is characterized by vigor, dedication and absorption. The aim of this scoping review is to identify factors associated with, and tools used to measure physician engagement. Methods: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and gray literature were searched. Supplementary articles were obtained by searching article references. All quantitative and qualitative study designs were eligible that described factors associated with, and tools used to measure, hospital physician engagement. Quantitative and qualitative analyses were conducted. Groupings and clustering were conducted to determine dominant groups or cluster of characteristics. Conceptual mapping was then conducted to identify patterns. Results: A total of 15 studies fulfilled the eligibility criteria. All were published between 2012 and 2017. Studies were predominantly conducted in Germany (n=8). Factors associated with physician engagement were synthesized into individual characteristics (n=7), work environment characteristics (n=7), and work outcomes (n=5). The Utrecht Work Engagement Scale was the most commonly used tool (n=14). Conclusions: This scoping review provides a strong evidence-based platform to further advance knowledge in the area of physician engagement. The identification of environmental factors assists hospital administrative leaders in understanding how they might intervene to affect engagement, while the identification of individual characteristics enable identification of vulnerable physicians, permitting identification of the most pertinent targeted areas for focus.

<p>Physician engagement: a concept analysis</p>

“…Given that “physician engagement” is a psychological concept, one might expect that work to date has drawn on the rich research history of the related concept of “work engagement” developed in the organizational behavior and work psychology literature 6. This, however, is not the case.…”

“…This study selected “physician engagement” as a concept. Despite the fact that physician engagement is beneficial to organizations, there appears to be widespread and ambiguous use of the term 6. The lack of conceptual clarity around the term “physician engagement” makes it challenging to measure and improve.…”

“…Physician engagement is often identified as being crucial to high-performing health care organizations1,2 with improved patient care outcomes and cost reduction 1,3,4. However, due to the wide use of the term, it remains a quite nebulous concept5,6 resulting in little consensus on appropriate measurement and minimal empirical evidence demonstrating the association between the engagement of physicians and improved outcomes. Although far less prominent in the literature are the terms “medical engagement” and “doctor engagement,” with the latter most prominent in Europe.…”

<p>Does physician engagement affect satisfaction of patients or resident physicians?</p>

“…Physician engagement has been defined as “vigor, dedication, and absorption” in work and to the organization to ensure success 10–13. Factors that drive physician engagement have been reported to include a sense of purpose, meaningful work, and belief that the organization is committed to high-quality patient care whereas physician disengagement may reflect dissatisfaction with work resources, organizational leadership, and work overload 12,13…”

“…To assess outpatient experience, the Centers for Medicare and Medicaid Services requires physician groups of 100 or more to use the CGCAHPS patient satisfaction survey 17. To assess physician engagement, the Utrecht Work Engagement Scale was found to be the most common tool used in studies measuring physician engagement, none of which were based in the US 12. In the US, health systems and hospitals commonly partner with health care survey consultants such as Press Ganey or Gallup to conduct proprietary surveys.…”