Volume 8 no 4
Strategies for enabling physician leadership and involvement in quality improvement: a scoping review
Pamela Mathura, PhD student, Tarek Turk, Liz Dennett, MLIS, Karen Spalding, PhD, Lenora Duhn, PhD, Narmin Kassam, MD, and Jennifer Medves, PhD
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A scoping review was completed following the framework of Arksey and O’Malley10 and applying the PRISMA-ScR checklist for reporting.11 For this review, a physician is defined as a medical doctor practising in any medical discipline and not a medical trainee (resident/housestaff or fellow). A physician-led health care QI model/approach is defined as one in which physicians are in a leadership position (i.e., quality or safety lead, quality officer, QI mentor) with a focus on QI and or patient safety (PS) and are leading the model/approach; there is collaboration among physicians to lead the learning of SI while participating in QI/PS projects with other health care professionals; and a physician is leading QI implementation.
Based on the 11 included articles7,14-23 (Table 1), physician-led QI models/approaches that include learning SI and are exclusively physician-led are few in number and the designs and formats vary. Among the 11 articles, we identified nine unique physician-led models/approaches. The model, HELP consortium, was described in two articles15,16: one about the model’s proposal and the other about findings after two years. The same model (physician quality officer) is mentioned in two articles19,21 and, in another, the authors refer to the model website.22 Articles were published from 2005 to 2020 and were model/approach descriptions with or without evaluation.7,14-23 Most articles represent North American experiences (eight from the USA and two from Canada), with one from the United Kingdom. The models/approaches were referred to as a program (n = 5)14,19,21-23, a committee (n = 3)7,17,18, a model20 (n = 1), or consortium (n = 2).15,16 Funding came from a hospital, a grant, the government, a combination of the three,7,15-17,19-23 or was not provided.18 Geographic coverage and influence is large, with six of nine models/approaches structured across a province, state, region, or country, and three within hospitals. The number of physician members ranged from 7 to over 100, and medical specialties varied.