Systematic literature review: An analysis of administrative strategies to engage providers in hospital quality initiatives

Provider engagement in hospital quality initiatives is receiving increased attention in a pay-for-performance era. The traditional hospital-physician alignment structure has not promoted provider engagement in system-wide quality initiatives. This systematic literature review analyzes provider engagement strategies. Selected articles were required to introduce administrative strategies that engage providers in hospital quality initiatives. A PubMed search uncovered 196 articles using the following keywords: “provider* OR physician*, AND hospital*, AND quality, AND engage*. Providers were defined as physicians, fellows, residents, physician assistants, or advanced practice nurses. The following filters were applied during the search: English language, humans, and published in the last 5 years. A total of 45 articles met the inclusion criteria. The reported strategies comprised financial incentives, public or private reporting, removing barriers, provider leadership, and hospital-provider alignment. Each reported strategy demonstrated gains within a quality initiative. However, it remains unclear whether these surrogate measures reflected provider engagement or other phenomena.