How can hospitals keep doctors positively engaged with their work?
Individual and work-related factors may be helpful in promoting positive engagement with work among hospital physicians, according to a study in the December issue of Medical Care.
The study provides insights into the emerging evidence on the characteristics and outcomes affecting physician engagement—an area of growing focus in healthcare improvement efforts. "By understanding how individual and work characteristics impact engagement, hospital administrator leaders are better positioned to positively approach physician engagement within their hospitals," write Tyrone A. Perreira, Ph.D., MEd, and colleagues of University of Toronto and the Ontario Hospital Association.
Hospital Physician Engagement—Individual and Work-Related Factors
Building on the concept of "positive psychology," physician engagement is viewed as a critical factor for improving the quality and efficiency of healthcare, increasing physician satisfaction and retention, and improving patient safety and outcomes. "'Engagement' in healthcare is often defined as a positive, fulfilling work-related state of mind, which is characterized by vigor, dedication and absorption," Dr. Perreira and coauthors write.
In a scoping review, the researchers identified 15 studies of hospital physician engagement. Reflecting the growing interest in this concept, all of the studies were published between 2012 and 2017. Dr. Perreira and colleagues performed quantitative and qualitative analyses to identify factors associated with physician engagement, as well as its impact on work outcomes.
The studies identified a range of individual characteristics related to physician engagement. Younger physicians (aged 26 to 35) had the highest physician engagement scores, but more experienced doctors were also more engaged. Single physicians had higher engagement than married physicians. Among physicians with children, men had higher engagement than women. Several personal attributes were linked to higher engagement, including resiliency, self-efficacy (confidence in the ability to get things done), and optimism.
Work-related characteristics related to increased engagement included higher quality of work life and increased job resources—for example, high levels of job control and supervisory and organizational support. In contrast, high job stress and high job demands were linked to lower physician engagement. Based on limited data, high physician engagement was associated with some important work outcomes, including increased job satisfaction, increased work ability, and decreased medical errors.
The study provides a useful initial overview of the emerging research for hospitals seeking to improve physician engagement, Dr. Perreira and colleagues believe. Although hospital leadership can't do much to change individual characteristics such as physician age, gender, or family life, knowledge of these factors may help in targeting doctors for interventions to improve physician engagement.
In contrast, the work-related factors might be helpful in guiding steps to promote engagement in healthcare settings. "Preliminary findings support healthy work environments, which include a good work-life balance, fair scheduling, as well as decreased job stress and job demands such as work overload and/or overtime," the researchers write.
Dr. Perreira and colleagues highlight the need for further research on hospital physician engagement, including the impact on key outcomes such as job satisfaction and patient safety. The authors believe their study provides a "strong evidence-based platform to further advance knowledge around physician engagement—which may lead to new strategies to improve the hospital work environment, with the ultimate outcome of improving patient care.