The growing pains of physician-administration relationships in an academic medical center and the effects on physician engagement
Eric J. Keller, Brad Giafaglione, Howard B. Chrisman, Jeremy D. Collins, Robert L. Vogelzang*
Background Physician engagement has become a key metric for healthcare leadership and is associated with better healthcare outcomes. However, engagement tends to be low and difficult to measure and improve. This study sought to efficiently characterize the professional cultural dynamics between physicians and administrators at an academic hospital and how those dynamics affect physician engagement. Materials and methods A qualitative mixed methods analysis was completed in 6 weeks, consisting of a preliminary analysis of the hospital system's history that was used to purposefully recruit 20 physicians across specialties and 20 healthcare administrators across management levels for semi-structured interviews and observation. Participation rates of 77% (20/26) and 83% (20/24) were achieved for physicians and administrators, respectively. Cohorts consisted of equal numbers of men and women with experience ranging from 1 to 35 years within the organization. Field notes and transcripts were systematically analyzed using an iterative inductive-deductive approach. Emergent themes were presented and discussed with approximately 400 physicians and administrators within the organization to assess validity and which results were most meaningful. Results & discussion This investigation indicated a professional cultural disconnect was undermining efforts to improve physician engagement. This disconnect was further complicated by a minority (10%) not believing an issue existed and conflicting connotations not readily perceived by participants who often offered similar solutions. Physicians and administrators felt these results accurately reflected their realities and used this information as a common language to plan targeted interventions to improve physician engagement. Limitations of the study included its cross-sectional nature with a modest sample size at a single institution. Conclusions A qualitative mixed methods analysis efficiently identified professional cultural barriers within an academic hospital to serve as an institution-specific guide to improving physician engagement.
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Keller, E. J., Giafaglione, B., Chrisman, H. B., Collins, J. D., & Vogelzang, R. L. (2019). The growing pains of physician-administration relationships in an academic medical center and the effects on physician engagement. PloS one, 14(2), [e0212014]. https://doi.org/10.1371/journal.pone.0212014
Keller, Eric J. ; Giafaglione, Brad ; Chrisman, Howard B. ; Collins, Jeremy D. ; Vogelzang, Robert L. / The growing pains of physician-administration relationships in an academic medical center and the effects on physician engagement. In: PloS one. 2019 ; Vol. 14, No. 2.
@article{e9c35718c0834c10949f418e01c2f3ae,
title = "The growing pains of physician-administration relationships in an academic medical center and the effects on physician engagement",
abstract = "Background Physician engagement has become a key metric for healthcare leadership and is associated with better healthcare outcomes. However, engagement tends to be low and difficult to measure and improve. This study sought to efficiently characterize the professional cultural dynamics between physicians and administrators at an academic hospital and how those dynamics affect physician engagement. Materials and methods A qualitative mixed methods analysis was completed in 6 weeks, consisting of a preliminary analysis of the hospital system's history that was used to purposefully recruit 20 physicians across specialties and 20 healthcare administrators across management levels for semi-structured interviews and observation. Participation rates of 77% (20/26) and 83% (20/24) were achieved for physicians and administrators, respectively. Cohorts consisted of equal numbers of men and women with experience ranging from 1 to 35 years within the organization. Field notes and transcripts were systematically analyzed using an iterative inductive-deductive approach. Emergent themes were presented and discussed with approximately 400 physicians and administrators within the organization to assess validity and which results were most meaningful. Results & discussion This investigation indicated a professional cultural disconnect was undermining efforts to improve physician engagement. This disconnect was further complicated by a minority (10%) not believing an issue existed and conflicting connotations not readily perceived by participants who often offered similar solutions. Physicians and administrators felt these results accurately reflected their realities and used this information as a common language to plan targeted interventions to improve physician engagement. Limitations of the study included its cross-sectional nature with a modest sample size at a single institution. Conclusions A qualitative mixed methods analysis efficiently identified professional cultural barriers within an academic hospital to serve as an institution-specific guide to improving physician engagement.",
author = "Keller, {Eric J.} and Brad Giafaglione and Chrisman, {Howard B.} and Collins, {Jeremy D.} and Vogelzang, {Robert L.}",
note = "Publisher Copyright: Copyright: {\textcopyright} 2019 Keller et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",
doi = "10.1371/journal.pone.0212014",
journal = "PLoS One",
publisher = "Public Library of Science",
Keller, EJ, Giafaglione, B, Chrisman, HB, Collins, JD & Vogelzang, RL 2019, 'The growing pains of physician-administration relationships in an academic medical center and the effects on physician engagement', PloS one, vol. 14, no. 2, e0212014. https://doi.org/10.1371/journal.pone.0212014
The growing pains of physician-administration relationships in an academic medical center and the effects on physician engagement. / Keller, Eric J.; Giafaglione, Brad; Chrisman, Howard B.; Collins, Jeremy D.; Vogelzang, Robert L.
In: PloS one, Vol. 14, No. 2, e0212014, 02.2019.
T1 - The growing pains of physician-administration relationships in an academic medical center and the effects on physician engagement
AU - Keller, Eric J.
AU - Giafaglione, Brad
AU - Chrisman, Howard B.
AU - Collins, Jeremy D.
AU - Vogelzang, Robert L.
N1 - Publisher Copyright: Copyright: © 2019 Keller et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
N2 - Background Physician engagement has become a key metric for healthcare leadership and is associated with better healthcare outcomes. However, engagement tends to be low and difficult to measure and improve. This study sought to efficiently characterize the professional cultural dynamics between physicians and administrators at an academic hospital and how those dynamics affect physician engagement. Materials and methods A qualitative mixed methods analysis was completed in 6 weeks, consisting of a preliminary analysis of the hospital system's history that was used to purposefully recruit 20 physicians across specialties and 20 healthcare administrators across management levels for semi-structured interviews and observation. Participation rates of 77% (20/26) and 83% (20/24) were achieved for physicians and administrators, respectively. Cohorts consisted of equal numbers of men and women with experience ranging from 1 to 35 years within the organization. Field notes and transcripts were systematically analyzed using an iterative inductive-deductive approach. Emergent themes were presented and discussed with approximately 400 physicians and administrators within the organization to assess validity and which results were most meaningful. Results & discussion This investigation indicated a professional cultural disconnect was undermining efforts to improve physician engagement. This disconnect was further complicated by a minority (10%) not believing an issue existed and conflicting connotations not readily perceived by participants who often offered similar solutions. Physicians and administrators felt these results accurately reflected their realities and used this information as a common language to plan targeted interventions to improve physician engagement. Limitations of the study included its cross-sectional nature with a modest sample size at a single institution. Conclusions A qualitative mixed methods analysis efficiently identified professional cultural barriers within an academic hospital to serve as an institution-specific guide to improving physician engagement.
AB - Background Physician engagement has become a key metric for healthcare leadership and is associated with better healthcare outcomes. However, engagement tends to be low and difficult to measure and improve. This study sought to efficiently characterize the professional cultural dynamics between physicians and administrators at an academic hospital and how those dynamics affect physician engagement. Materials and methods A qualitative mixed methods analysis was completed in 6 weeks, consisting of a preliminary analysis of the hospital system's history that was used to purposefully recruit 20 physicians across specialties and 20 healthcare administrators across management levels for semi-structured interviews and observation. Participation rates of 77% (20/26) and 83% (20/24) were achieved for physicians and administrators, respectively. Cohorts consisted of equal numbers of men and women with experience ranging from 1 to 35 years within the organization. Field notes and transcripts were systematically analyzed using an iterative inductive-deductive approach. Emergent themes were presented and discussed with approximately 400 physicians and administrators within the organization to assess validity and which results were most meaningful. Results & discussion This investigation indicated a professional cultural disconnect was undermining efforts to improve physician engagement. This disconnect was further complicated by a minority (10%) not believing an issue existed and conflicting connotations not readily perceived by participants who often offered similar solutions. Physicians and administrators felt these results accurately reflected their realities and used this information as a common language to plan targeted interventions to improve physician engagement. Limitations of the study included its cross-sectional nature with a modest sample size at a single institution. Conclusions A qualitative mixed methods analysis efficiently identified professional cultural barriers within an academic hospital to serve as an institution-specific guide to improving physician engagement.
U2 - 10.1371/journal.pone.0212014
DO - 10.1371/journal.pone.0212014
JO - PLoS One
JF - PLoS One
M1 - e0212014
Keller EJ, Giafaglione B, Chrisman HB, Collins JD, Vogelzang RL. The growing pains of physician-administration relationships in an academic medical center and the effects on physician engagement. PloS one. 2019 Feb;14(2). e0212014. https://doi.org/10.1371/journal.pone.0212014