While physicians are essential to hospital quality improvement efforts, competing time and financial pressures are hurdles to their participation, according to a study by the Center for Studying Health System Change.

Many hospitals historically have relied on the voluntary medical staff model to solicit physician participation. However, as more services shift to outpatient settings and physicians confront quality-of-life issues and financial stresses, they feel less obligated to participate in hospital activities, including quality improvement, according to the study.

Using interviews with hospital leaders in four cities, the study identified the following strategies to involve physicians in quality improvement activities:

  • Employ physicians: Typically, quality improvement is not the main driver behind tighter alignment of physicians and hospitals, but employment can create incentives for physician involvement by lessening competing pressures on physicians' time and increasing their accessibility and visibility in the hospital.
  • Use data: Credible data to identify areas that need improvement and systematically assess progress are essential to securing physician participation. Many respondents recounted how physicians assume they are providing good quality of care until they are shown data proving otherwise.
  • Visible commitment: An important role of hospital leadership is creating a strong quality culture by publicly demonstrating that quality improvement is important, supported and encouraged.
  • Develop champions: Physician involvement reportedly is often limited to a fraction of the active medical staff. Finding ways to engage more physicians is essential to quality improvement efforts, which ultimately require all medical staff members to adopt process and practice changes.
  • Demonstrate value: In soliciting physician involvement in quality improvement, hospital leaders reported that showing physicians that quality improvement activities improve patient outcomes and aren't just administrative or regulatory requirements increases their willingness to participate.

For more information, go to www.hschange.org.