Exploring the concept of "clinical engagement" and its implications: a scoping review

Healthcare systems are strongly committed to improve their performance levels in terms of effectiveness, efficiency, and appropriateness. The development of better and more effective ways to direct professional behaviour... [ view full abstract ]

Healthcare systems are strongly committed to improve their performance levels in terms of effectiveness, efficiency, and appropriateness. The development of better and more effective ways to direct professional behaviour coherently towards these objectives represents one of the most significant issues of health policies. Over recent years academics and policy-makers have focused on the issue of clinical engagement, that is the willingness of clinicians to actively participate in management of their healthcare organisation, also taking direct responsibility for the decision-making processes. The involvement of clinicians in the management of the healthcare organizations can take different forms, and clinicians are required to enrich their skills with management practices and shape the direct relationship with administrative and specialist managers. Our goal is to address the broad issue of “clinical engagement” in healthcare organizations and the relationship with administrative roles. We choose a specific methodological approach to analyse the literature: the scoping review. Scoping reviews are especially useful when addressing broad concepts and issues, rather than focusing on a clearly and narrowly defined research question as it is typically the case in systematic reviews. The method of scoping reviews appears to be justified by the fact that we need to face this research question not punctually defined in its connotation, but rather by exploring a general theme, which could be interpreted differently and have different forms of contextualisation according to the contexts in which it was drawn up, with respect to which the main task is to systematically "map" what has been tackled up to now. A literature assessment was undertaken in 2015. Snowballing technique, reference tracking, and a systematic search of different academic databases were conducted to identify peer reviewed published studies. Selection criteria were applied across different phases and about 100 studies were included in the final analysis and synthesis.