Physician-led quality improvement: a blueprint for building capacity

Abstract

Physicians have a vital role to play in health system transformation, and their committed involvement provides an opportunity for comprehensive improvement and change. Health care has been shifting to a team-based, integrated, and collaborative approach, with a greater expectation for physicians to engage and lead quality improvement (QI). However, there are many barriers to physician QI capability, participation, and leadership. A physician leader at a university and a provincial health care organization’s executive director recognized this challenge and developed an innovative coalition, the Strategic Clinical Improvement Committee, to build organizational capacity for physician-led QI. Six key principles and approaches underpin the coalition: QI as inseparable from care, accountability, a team approach, organic growth through training, academic credibility, and return on investment, including 14 enabler strategies. To date, achievements include the completion of over 60 physician-led QI projects, development of a summer health care improvement elective course, receipt of grants totaling $250 000, 16 QI papers published in peer-reviewed journals, and numerous projects shared nationally and internationally at conferences. The coalition has propelled a shift toward a physician-led improvement culture at the direct care level. The criticality of sustaining this culture of physician QI engagement and leadership will require balancing competing priorities, limited resources, and various other health system influences.