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 TRUST
Regulated Health Professions Act The Objects • In carrying out its objects: The College has a duty to serve and protect the public interest. College of Physicians and Surgeons of Ontario QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST
Our Vision Quality professionals, healthy system, public trust 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 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 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. 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. College of Physicians and Surgeons of Ontario QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST
Distribution of Grades Assigned to GPs/FPs in 2008 (Total: 371) Random Sample (n = 280) Age Selected (70 and 70+) Sample (n = 91) 10.98% 2.85% 11.78% 20.87% Satisfactory Reassessments Practice Concerns 68.13% 85.35% College of Physicians and Surgeons of Ontario QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST
Educational Value of Peer Assessments (n=4,663) 1%4% 15% Very Low 40% Low Moderate High Very High 40% Decima Research 2006 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: 1,184 – 2008 Target of 1,000 completed assessments – 2009 Target - 1,300 – And… Target: 2,000 by 2010 College of Physicians and Surgeons of Ontario QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST
Putting the ‘self’ in self-regulation Assessor Networking Groups Determine Physician Perceived needs Unperceived needs Practice Improvement Needs, Set Standards, • New knowledge • Identified by physicians Implement Protocols • System-level data based on assessment • Unique perspective experience Assessors College of Physicians and Surgeons of Ontario QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST
Physician Practice Improvement Towards Enhancing Quality of Care across Primary Care System in Ontario Connecting with Peers Assessor Networking Groups Strategic Plan: Specialty Societies 2,000 assessments by 2010 Practice Connecting with other improvement jurisdictions topics, Connecting with Partners targets and i.e. Reciprocity initiatives tools i.e. QIPP, OCFP, CFPC, CEP, (eg. Quebec, United States), MOHLTC, QFP, CPDO and Alternative Pathways, RPA Quality Health Council Partners engaged in College Themes practice enhancement College College of Physicians and Surgeons of Ontario and improvement QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST
Quality Management Division, CPSO Resources • Medical Officers • Staff Contacts – Angela Carol MD, ext 288 – Daniel Faulkner, Director, QM acarol@cpso.on.ca – Maureen Gans, – Daniel Klass MD….... 338 Manager, QA – Bill McCauley MD..... 434 Program – Daniel Way MD……. 401 – Rhoda Reardon, Acting Manager, Research & • Website Evaluation www.cpso.on.ca College of Physicians and Surgeons of Ontario QUALITY PROFESSIONALS | HEALTHY SYSTEM | PUBLIC TRUST
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