Exploring the Connection between Physician Involvement in Quality Improvement and Medical Engagement
Notice bibliographique
Résumé
Substantial efforts are required to improve the performance of healthcare systems, however, healthcare organizations tend to have structures and cultures that are highly resistant to change. Though such resistance will make significant changes in healthcare challenging there has been a call for reform in Canada’s healthcare system (e.g. Atkinson et al., 2011; CMA, 2012; Clark, 2012; Denis et al., 2013; Dickinson Ham, 2008; Dickson, 2011; Gosfield Reinertsen, 2007; Kirby, 2002; Romanow, 2002; Tuohy, 1999, 2002; Willis et al., 2012).Medical engagement has been suggested as one means of achieving this desired reform and overcoming the challenges of resistance to change (Baker Denis, 2011; Singer Shortell, 2011). Similarly, the involvement of physicians in quality improvement has been purported to contribute to improved health outcomes and decreased costs (Peterson, Jaen Phillips, 2013). Baker Denis (2011) note that many of the growing efforts to engage physicians in leading change are focused on changes in organizational structure and in broader system-wide leadership; however, there have been few studies examining the extent to which these changes have resulted in the enhanced levels of engagement. Similarly absent is empirical work examining the role of physician involvement in quality improvement in building medical engagement, despite suggestions that both will contribute to enhanced organizational and systems outcomes. The role that organizational commitment has on medical engagement is also of interest, given the recognized theoretical links between commitment and engagement. This thesis reports a mixed methods investigation to explore the connection between physician involvement in quality improvement, organizational commitment and medical engagement levels in two healthcare organizations in Ontario. In the first phase of the inquiry, organizational commitment and organizational support for quality improvement were quantified in a survey to determine the relationship among these concepts. The secondary, qualitative phase, allows for a deeper understanding of physicians’ perspectives regarding the connection between quality improvement, organizational commitment and medical engagement while exploring the results of the survey. Overall, this dissertation furthers our knowledge of how Canadian healthcare organizations can effectively work with physicians to drive changes to improve healthcare.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».