Australian doctors are more engaged than UK doctors: why is this the case?

BACKGROUND: Despite reports highlighting the need for greater medical engagement and the benefits of being widely understood, very little information is available on the status of medical engagement in Australia, and how this compares to the UK. Answering this question will no doubt assist training bodies, curriculum designers and policy makers better understand relevant issues. METHODS: The medical engagement questionnaire (MES) was emailed to all medical staff working at 159 UK National Health Service Trusts and 18 health service organisations in Australia. The questionnaire consists of 30 predetermined items seeking responses using a 5-point Likert scale. RESULTS: Overall, doctors in the Australian dataset are slightly more engaged, or more positive, than their UK colleagues. Good interpersonal relationships was the only variable that UK doctors scored more positively than their Australian counterparts. At the lower end of the responses, that is the least engaged, we found this even more apparent. Where doctors in Australia are less disengaged, that is still more positive than the UK colleagues. CONCLUSION: While the profiles of medical engagement vary at the sites and also across the MES and subscales, the data illustrate that overall doctors in Australia feel valued and empowered, and they have purpose and direction and work in a collaborate culture. At the most disengaged end of the scale, Australian doctors are markedly less disengaged than their UK counterparts. There may be numerous factors that influence and change how engaged doctors are in both countries. The most prominent of these are appear to be working conditions and lifestyle, driven by funding and other economics issues. This research is likely to be of great interest to regulators and training bodies in both countries.

The Relationships Between Use of Quality-of-Care Feedback Reports on Chronic Diseases and Medical Engagement in General Practice.

BACKGROUND: There is a limited knowledge on how medical engagement influences quality of care provided in primary care. The extent of the use of feedback reports from a national quality-of-care database can be considered as a measure of process quality. This study explores relationships between the use of feedback reports and medical engagement among general practitioners, general practitioner demographics, clinic characteristics, and services. METHODS: A cross-sectional combined questionnaire and register study in a sample of 352 single-handed general practitioners in 2013. Logistic regression analysis was used to explore associations between the use of feedback reports for diabetes and chronic obstructive pulmonary disease and medical engagement. RESULTS: For both diabetes and chronic obstructive pulmonary disease, a higher degree of medical engagement was associated with an increased use of feedback reports. Furthermore, we identified positive associations between using feedback reports and general practitioner services (spirometry, influenza vaccinations, performing annual reviews for patients with chronic diseases) and a negative association between usage of quality-of-care feedback reports and the number of consultations per patient. CONCLUSION: Using feedback reports for chronic diseases in general practice was positively associated with medical engagement and also with the provision of services in general practice.

The organizational stress measure: an integrated methodology for assessing job-stress and targeting organizational interventions.

This paper briefly describes the OSM (Organizational Stress Measure) which was developed over a decade ago and has evolved to become a well-established practical method not only for assessing wellbeing at work but also as a cost-effective strategy to tackle workplace stress. The OSM measures perceived organizational pressures and felt individual strains within the same instrument, and provides a rich and subtle picture of both the organizational culture and the personal perspectives of the constituent staff groups. There are many types of organizational pressure that may impact upon the wellbeing and potential effectiveness of staff including skill shortages, ineffective strategic planning and poor leadership, and these frequently result in reduced performance, absenteeism, high turnover and poor staff morale. These pressures may increase the probability of some staff reacting negatively and research with the OSM has shown that increased levels of strain for small clusters of staff may be a leading indicator of future organizational problems. One of the main benefits of using the OSM is the ability to identify 'hot-spots', where organizational pressures are triggering high levels of personal strain in susceptible clusters of staff. In this way, the OSM may act as an 'early warning alarm' for potential organizational problems.

Medical engagement: a crucial underpinning to organizational performance.

Medical Engagement has long been advocated as a critical component relating to organizational performance. Relatively little data though existed to support this contention. Using the Medical Engagement Scale (MES) This study demonstrates a persuasive linkage between assessed levels of Medical Engagement in secondary care organizations and independently gathered performance measures. Implications of executive leaders in promoting engagement are explored.

A management control approach to monitor large-scale change: an illustration in the context of reconfiguration.

The paper describes how Hospital Episode Statistics (HES) data can be retrospectively analysed over a number of years to evaluate and monitor organizational change in National Health Service (NHS) trusts. A methodology based on joinpoint regression analysis and management control theory has been developed which is able to represent in a framework (called an 'activity map') the complexity of HES data in a more user-friendly way than the unwieldy and often overwhelming tables or spreadsheets that are typically utilized. The 'activity map' has been designed to provide a common frame of reference for health professionals from different backgrounds to visualize and interpret the actual patterns of hospital activity changes that have occurred over the years. The aim is to facilitate a more effective, faster and more intuitive exploration of very large and unwieldy HES data-sets to assist health-care staff in monitoring planned and unplanned activity changes. It is hoped that making HES data more easily assimilated will encourage a greater sense of meaningful engagement in creatively contributing to service innovation.