WASHINGTON – A study released Thursday by the Center for Studying Health System Change shows that some hospitals have found ways to urge community physicians to engage in quality improvement and reporting programs.

Hospitals have historically relied on volunteer efforts from community physicians to engage in quality improvement activities. As the stress level increases for physicians, however, fewer are willing to participate.

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

"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 Draper, HSC's associate director and co-author of the study with Allison Liebhaber, a former HSC health research analyst, and Genna 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 found that while respondents often described medical staff bylaws as encouraging physicians to "be good citizens" and participate in quality improvement activities, those bylaws often lack the specificity or accountability that clearly outline physicians' responsibilities.

Researchers also found that hospitals are employing more physicians, giving them an opportunity to provide incentives to those who participate in quality improvement efforts.

Researchers say credible data that identifies areas that need improvement and assesses progress is essential to securing physician participation in hospital quality improvement efforts. Many responses said physicians assume they are providing quality care until they are shown data proving otherwise.

Other findings include:

• Visible commitment by hospital leadership can foster physician involvement in quality improvement activities.
• Finding ways to engage more physicians is critical to quality improvement, which ultimately requires all members of the medical staff to adopt process and practice changes.
• Hospital leaders reported the importance of clear communication, including showing physicians that quality improvement activities improve patient outcomes.