The role of physician engagement on the impact of the hospital-based practice improvement module (PIM).

BACKGROUND: Physicians play an important role in hospital quality improvement (QI) activities. The Hospital-Based Practice Improvement Module (Hospital PIM) is a web-based assessment tool designed by the American Board of Internal Medicine (ABIM) to facilitate physician involvement in QI as a part of maintaining certification.
OBJECTIVE: The primary objective of this study is to explore the impact of the Hospital PIM on physicians participating in hospital-based QI.
DESIGN: Qualitative design consisting of semistructured telephone interviews. PARTICIPANTS: A purposeful sample of 21 early-completers of the Hospital PIM. MEASUREMENTS: Grounded-theory analysis was used to analyze transcripts of the semistructured telephone interviews.
RESULTS: Physician completers of the Hospital PIM describe the impact in a variety of ways, including new learning about QI principles and activities, added value to their practice, and enhanced QI experience. An emerging theme was the mediating role of physician engagement in relation to the overall impact of the Hospital PIM. Four case studies illustrate these findings. Facilitators and barriers that influence the overall experience of the PIM are described.
CONCLUSIONS: The impact of completing the Hospital PIM is mediated by the degree of physician engagement with the QI process. Physicians who become engaged with the Hospital PIM and QI process may be more likely to report successful experiences in implementing QI activities in hospital settings than those who do not become engaged. Copyright 2009 Society of Hospital Medicine