Lack of Physician Participation is Hindering Quality Efforts

Time constraints, financial pressures, and a waning sense of obligation to hospitals are hindering physician participation in hospital quality improvement efforts, according to a study by the Center for Studying Health System Change.

"Many physicians are spending less time in hospitals and increasingly are reticent about voluntarily giving their time to hospitals, so finding effective ways to engage physicians in quality improvement is an important challenge for hospitals," says Debra A. Draper, HSC associate director and a coauthor of the study. "While hospitals are making gains in quality, greater alignment of hospitals and physicians working together on quality improvement would likely spur considerably more improvement."

The study, Hospital Strategies to Engage Physicians in Quality Improvement, interviewed hospital leaders in Detroit, Memphis, Minneapolis-St. Paul, and Seattle, and identified strategies to involve physicians in quality improvement initiatives, including employing physicians; using credible data to identify areas needing improvement; providing visible hospital leadership support; identifying and nurturing physician champions to help engage their peers; and communicating the importance of physicians' contributions.

Hospitals historically have relied on the voluntary medical staff model to solicit physician participation—a model generally premised on a loose affiliation between hospitals and community-based physicians. However, as more services shift to outpatient settings and physicians confront quality-of-life issues and financial stresses, physicians feel less obligated to volunteer time for hospital activities, including quality improvement, according to the study, which was funded by the Robert Wood Johnson Foundation.