Assignment: Opportunities in Physician Engagement Column

• Review Chapters 7-10 in the textbook (Fried & Fottler, 2015).
• Review the PowerPoints posted on Blackboard.
• Use critical thinking skills and metacognition and read the Case Study:  Physician Engagement in the textbook on page 542.
• Joyce, the Vice President of Human Resources (HR), selected your team to address the case study on Physician Engagement.   Copper River Community Hospital is an independent, not-for-profit 275-bed hospital located in Copper River (pop. 24,000), a rural community in the Midwest.  It is located about 200 miles from a medium-sized city (pop. 130,000).  It has faced problems related to decreased revenue and staff turnover.
• Consider the strengths, weaknesses, opportunities, and threats (SWOT) that may include political, economic, sociological, technological, legal, and environmental (PESTLE) Analysis.
• On one sheet of paper, create a four-column table and make a list of the strengths, weaknesses, opportunities, and threats (SWOT) that impact physician engagement based on the case study.

The term “physician engagement” is used quite frequently, yet it remains poorly defined and measured. The aim of this study is to clarify the term “physician engagement.” This study used an eight step-method for conducting concept analyses created by Walker and Avant. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched on February 14, 2019. No limitations were put on the searches with regard to year or language. Results identify that the term “physician engagement” is regular participation of physicians in (1) deciding how their work is done, (2) making suggestions for improvement, (3) goal setting, (4) planning, and (5) monitoring of their performance in activities targeted at the micro (patient), meso (organization), and/or macro (health system) levels. The antecedents of “physician engagement” include accountability, communication, incentives, interpersonal relations, and opportunity. The results include improved outcomes such as data quality, efficiency, innovation, job satisfaction, patient satisfaction, and performance. Defining physician engagement enables physicians and health care administrators to better appreciate and more accurately measure engagement and understand how to better engage physicians.

Keywords: physician, medical, engagement, concept analysis
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Introduction
Physician engagement is often identified as being crucial to high-performing health care organizations1,2 with improved patient care outcomes and cost reduction.1,3,4 However, due to the wide use of the term, it remains a quite nebulous concept5,6 resulting in little consensus on appropriate measurement and minimal empirical evidence demonstrating the association between the engagement of physicians and improved outcomes. Although far less prominent in the literature are the terms “medical engagement” and “doctor engagement,” with the latter most prominent in Europe. Regardless, all terms refer to physicians/medical doctors.

Traditionally, physicians worked independently and were not considered hospital employees, with a focus on patient care and clinical decision-making.7 Physicians have long emphasized their critical role as patient advocates and held themselves accountable for effective care. To be effective patient advocates, doctors believed that it was important for them to have clinical self-government to determine the best care required, while the focus of health care executives and administrators was financial management.7

More recent demands on health service organizations to reform and improve their performance around patient experiences and cost-of-care reductions have led to a recognition that physicians can contribute in an important way in addressing these demands.8

It is essential to align physicians with organizational and system aims and activities, engaging physicians in both setting the course for system change and ensuring optimal execution of the desired system changes. (p. 2)8

New expectations have physicians taking on additional roles and activities perceived as “organizational imperatives” rather than “direct patient care”, creating a strong dichotomy between hospital leadership and frontline physicians, or an “us versus them” environment.8

Thus, abundant of time and resources are spent discussing and trying to “engage” physicians.5 Non engagement of clinicians has been a long-standing, international, and complex problem.9 A literature review on health care professional views on engagement in quality improvement identified that health care professionals are reluctant to engage, mainly because they perceive that initiatives will be ineffective, will be a waste of scarce personal and organizational resources, and are concerned about harmful effects that may result from quality initiatives.9

Although some scholars in the field may have a clear understanding of the term “physician engagement,” it has become evident from discussions with Canadian health care administrators and physician leaders and review of the literature, this concept is still poorly understood and measured. This conceptual “fuzziness” likely contributes to the lack of evidence in this area, making comparisons across settings challenging. Previous work in this area examining the evidence on physician engagement suggests that most of the articles published on this topic are non evidence-based and considered opinion pieces.10

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed

• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• The is a great resource