Exploring the dynamics of physician engagement and leadership for health system improvement

I ► IMPACT OF HEALTH SYSTEM CHALLENGES AND EVOLUTION ON PHYSICIAN ENGAGEMENT AND LEADERSHIP A. Health System Context and the Demand for Physician Engagement and Leadership The articles in this section examine the reactions or behaviours of physicians within the context of healthcare reforms. [...] II ► ORGANIZATIONAL DYNAMICS OF PHYSICIAN ENGAGEMENT AND LEADERSHIP A. Structural Dimensions A first stream of work in studies of organizational dynamics includes many papers dealing with structural determinants of physician engagement and leadership based on numerous empirical 10 Exploring the Dynamics of Physician Engagement and Leadership for Health System Improvement studies of hospitals and h [...] According to Weiner, Shortell and Alexander (1997), clinical involvement is a multidimensional construct incorporating elements that relate to the practice and activities of individual physicians, to the organization and management of work within clinical departments or units (including data management and information support), and to the characteristics of the overall organizational context. [...] The study points to the interaction of factors; for example, exposure to quality improvement collaboratives, 20 Exploring the Dynamics of Physician Engagement and Leadership for Health System Improvement provision of data and the emergence of a commitment to quality improvement in the practice are important to successful quality improvement efforts. [...] C. Policy Implications From Research on the Organizational Dimensions of Physician Engagement and Leadership Much of the literature dealing with the structural determinants of physician engagement and leadership is based on experiences in the US healthcare system and on the role of physicians in organizations under a shift to more managed care.