Enabling clinician engagement in safety and quality improvement

Objective. The aim of this study was to determine how individual, group and leadership factors influence clinician engagement in safety and quality improvement work. Methods. The study was conducted through an online questionnaire. Participants were alumni of Australian healthcare safety and quality improvement capability development programs. Relationships between five factors influencing clinicians' perception of value for time and effort in safety and quality improvement work were explored. The five factors were psychological empowerment; task cohesion; social cohesion; transformational leadership behaviour of project leads and sponsors; and value for time and effort for self and patients. Correlation and regression analyses were used to explore the aspects of the hypothesised model. Moderation and mediation analysis was then used to explore the relationships further. Structural equation modelling was used to determine the path model. Results. All factors showed strong positive correlations, with psychological empowerment and transformational leadership having the strongest relationships with perceived value for effort for self and patient. The factorial structure of measures was examined, and all indicators loaded significantly on their corresponding latent constructs and the model showed a good fit to the data. Conclusions. The findings of this study suggest that the most crucial factor to clinician engagement in safety and quality improvement at the point of care is the leader's behaviour and how that influences team dynamics and individual motivation and empowerment.