Celebrating Quality in Family Practice Internationally and in - - PowerPoint PPT Presentation

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Celebrating Quality in Family Practice Internationally and in - - PowerPoint PPT Presentation

Celebrating Quality in Family Practice Internationally and in Ontario Quality Assurance: I mprovement and Enhancement Angela Carol MD March 2009 College of Physicians and Surgeons of Ontario QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC


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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

Celebrating Quality in Family Practice Internationally and in Ontario

Angela Carol MD

March 2009

Quality Assurance: I mprovement and Enhancement

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

  • In carrying out its objects:

The College has a duty to serve and protect the public interest.

Regulated Health Professions Act The Objects

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

Our Vision Quality professionals, healthy system, public trust

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

Regulated Health Professions Act

“Quality assurance program” means…

A program to assure the quality of the practice of the profession and to promote continuing competence among the members

(Definitions, Health Professions Procedural Code)

Our Assessment Objectives: (a) To promote clinical competence and practice-based CPD. (b) To promote and assure standards of practice.

Quality Assessment = focus on practice evaluation & improvement

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

The Peer Assessment Program

  • Building on a Solid Foundation (since 1977)

– Early focus on rigour of assessment; – Research conducted by QM Division around evaluating clinical performance – Evolved to understanding clinical performance How we assess clinical performance is based on a solid foundation of rigour and research

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

Lessons learned from recent research done within QM Division, CPSO

About the Peer Assessment Process:

  • Introducing principles of CPD and knowledge translation into an

assessment for regulatory purposes can change behaviour.

  • Physicians accept educationally focused recommendations from

peers to improve practice.

  • Peers who work with colleagues to provide suggestions for

improvement to their practice require a structured training period to acquire the appropriate skills.

  • There are performance dimensions that inform our evaluation

methods which help focus CPD in order to meet individual performance needs of practicing physicians.

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

The Quality Improvement Approach

  • A prior assumption of competence for

practicing doctors

  • Competence is multidimensional and

relational…dyscompetence is a manifestation of complex system issues

  • System problems respond to ongoing

quality assurance efforts.

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

Distribution of Grades Assigned to GPs/FPs in 2008 (Total: 371)

Satisfactory Reassessments Practice Concerns

85.35% 11.78% 2.85% Random Sample (n = 280) Age Selected (70 and 70+) Sample (n = 91) 20.87% 10.98% 68.13%

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

Educational Value of Peer Assessments (n=4,663)

1%4% 15% 40% 40% Very Low Low Moderate High Very High

Decima Research 2006

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

Peer Assessment by Numbers

  • 282 CPSO Peer Assessors (2009)
  • Number of Assessments:

– 2008 Target of 1,000 completed assessments – 2009 Target - – And…

1,184

Target: 2,000 by 2010

1,300

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

Determine Physician Practice Improvement Needs, Set Standards, Implement Protocols Unperceived needs Perceived needs

  • New knowledge
  • System-level data
  • Unique perspective
  • Identified by physicians

based on assessment experience

Assessors

Putting the ‘self’ in self-regulation

Assessor Networking Groups

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

College Practice improvement topics, targets and tools

Partners engaged in practice enhancement and improvement

Assessor Networking Groups College Themes

Specialty Societies

Physician Practice Improvement Towards Enhancing Quality of Care across Primary Care System in Ontario Connecting with Peers Strategic Plan: 2,000 assessments by 2010

Connecting with Partners

i.e. QIPP, OCFP, CFPC, CEP, MOHLTC, QFP, CPDO and Quality Health Council

Connecting with other jurisdictions

i.e. Reciprocity initiatives (eg. Quebec, United States), Alternative Pathways, RPA

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College of Physicians and Surgeons of Ontario

QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST

Quality Management Division, CPSO Resources

  • Medical Officers

– Angela Carol MD, ext 288 acarol@cpso.on.ca – Daniel Klass MD….... 338 – Bill McCauley MD..... 434 – Daniel Way MD……. 401

  • Website

www.cpso.on.ca

  • Staff Contacts

– Daniel Faulkner, Director, QM – Maureen Gans, Manager, QA Program – Rhoda Reardon, Acting Manager, Research & Evaluation