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Abstract
Introduction Lack of physician involvement threatens the success and sustainability of quality improvement work (QIW).1–3 Few studies have assessed physicians´ interests and opportunities to be involved in QIW. It is therefore important to do so, both in hospital and general practice.
Methods Our aim was to determine the prevalence of physicians reporting active participation in QIW and the prevalence reporting an interest (without participation) in QIW. To understand the potential for improvement, we also needed to assess whether physicians’ opportunity and designated time to participate in QIW had an effect on their interest and active participation in QIW. Our hypothesis was that designated time promotes participation in QIW. This resonates with Donabedians’ structure, process and outcome framework.4 We conducted a cross-sectional postal survey on a representative sample of physicians in different job positions in Norway in 2019.
Results The response rate was 72.6% (1513 of 2085). A large proportion (85.7%) wanted to participate in QIW, and 68.6% had actively done so in the last year. Physicians’ active participation in QIW was significantly related to the designated time for QIW in their work schedule (p<0.001). Only 16.7% reported designated time for participation in QIW. Among those with designated time 86.6% participated in QIW, while 63.7% among those without designated time participated.
Discussion Physicians want to participate in QIW. They participate to a higher degree when they have designated time. Leaders can increase QIW participation from physicians by ensuring that time for this is part of the work schedule.
References
Davies H, Powell A, Rushmer R. Why don’t clinicians engage with quality improvement? J Health Serv Res Policy 2007;12(3):129–30.
Allwood D, Fisher R, Warburton W, Dixon J. Creating space for quality improvement. BMJ 2018;361:k1924.
Weigl M, Hornung S, Angerer P, Siegrist J, Glaser J. The effects of improving hospital physicians working conditions on patient care: a prospective, controlled intervention study. BMC Health Serv Res 2013;13:401.
Donabedian A. Promoting the quality through evaluating the process of patient care. Med Care 1968;VI(3):181–202.
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