The effects of improving hospital physicians working conditions on patient care: a prospective, controlled intervention study

Background: Physicians, particularly in hospitals, suffer from
adverse working conditions. There is a close link between
physicians' psychosocial work environment and the quality of the
work they deliver. Our study aimed to explore whether a
participatory work-design intervention involving hospital
physicians is effective in improving working conditions and quality
of patient care. Methods: A prospective, controlled intervention
study was conducted in two surgical and two internal departments.
Participants were 57 hospital physicians and 1581 inpatients. The
intervention was a structured, participatory intervention based on
continuous group meetings. Physicians actively analyzed problematic
working conditions, developed solutions, and initiated their
implementation. Physicians' working conditions and patients'
perceived quality of care were outcome criteria. These variables
were assessed by standardized questionnaires. Additional data on
implementation status were gathered through interviews. Results:
Over the course of ten months, several work-related problems were
identified, categorized, and ten solutions were implemented.
Post-intervention, physicians in the intervention departments
reported substantially less conflicting demands and enhanced
quality of cooperation with patients' relatives, compared to
control group physicians. Moreover, positive changes in enhanced
colleague support could be attributed to the intervention.
Regarding patient reports of care quality of care, patient ratings
of physicians organization of care improved for physicians in the
intervention group. Five interviews with involved physicians
confirm the plausibility of obtained results, provide information
on implementation status and sustainability of the solutions, and
highlight process-related factors for re-design interventions to
improve hospital physicians work. Conclusions: This study
demonstrates that participatory work design for hospital physicians
is a promising intervention for improving working conditions and
promoting patient quality of care.