Hospital Strategies to Engage Physicians in Quality Improvement

Hospitals Compete Against Physicians' Time/Financial Pressures for Involvement

News Release
Oct. 15, 2009

Alwyn Cassil (202) 264-3484 or

WASHINGTON, DC—While physicians are essential to hospital quality improvement efforts, competing time and financial pressures pose hurdles to physician participation, according to a study released today by the Center for Studying Health System Change (HSC).

Although hospitals have long engaged in quality improvement activities, they continue to face escalating demands to participate in a wide range of quality improvement and reporting programs. Many 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.

Funded by the Robert Wood Johnson Foundation, the study included interviews with hospital leaders in Detroit, Memphis, Minneapolis-St. Paul and Seattle and identified hospital strategies to involve physicians in quality improvement activities, 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.

"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," said Debra A. Draper, Ph.D., HSC associate director and coauthor of the study with Allison Liebhaber, a former HSC health research analyst, and Genna R. Cohen, an HSC health research assistant.

"While hospitals are making gains in quality, greater alignment of hospitals and physicians working together on quality improvement would likely spur considerably more improvement," Draper said

The study’s findings are detailed in a new HSC Issue Brief—Hospital Strategies to Engage Physicians in Quality Improvementavailable here. Other key study findings include:

To identify and promote policies and practices that encourage hospitals and physicians to work together to improve quality, the study concluded that policy makers driving the nation’s health care quality improvement agenda should consider:

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The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded in part by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research.