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A Brief Descripton of the Quality Project

Program / Project Name: McMaster University Quality in Family Practice Project

Brief Description:

  • The Quality Project was initiated in 2000 by McMaster University, Department of Family Medicine when Dr. Ronald MacVicar from Inverness, Scotland spent a year with us and together with our local faculty developed a Hamilton tool based on the Scottish Quality Practice Awards (QPA) assessment tool. 

  • 2003-2005 we were funded with the OCFP, by the PHCTF, for Phase I to undertake an international and national environmental scan and literature review, 13 focus groups and formal site visits to England and Scotland to recommend a voluntary interdisciplinary assessment program; develop and train Quality assessors; and develop a Quality Tool.

  • 2005-2006 we were funded for Phase 2 to test the Quality program and tool in three family practices – a rural large practice in Mount Forest, an urban large practice in Kitchener Waterloo and an urban solo practice in Hamilton. We developed the Quality video for explaining the program.

  • The results were very positive and the MOHLTC continued to invest in the development of the program by funding further field testing of the program and tool in Phase 3, in 2007-2008, in 7 Family Health Teams (FHT's).

  • 2007 we visited New Zealand and Australia to explore their accreditation programs and presented our video at Wonca, Singapore.

  • In 2008-2009 the MOH LTC funded a modified Delphi process to refine the Quality tool

  • In 2008-2009 the OCFP and McMaster adapt some of the existing outreach presentations/training workshops materials, develop additional training resources on the Quality Assessment Tool and develop them into an Internet-based e-learning program.

  • 2009 we host the CQIO (Celebrating Quality Internationally and in Ontario) and purposely partner with other quality organizations and stakeholders to develop a longer term vision.

Time frame:  Ongoing since 2000.

Numbers / Locations of Primary Care practices or practitioners involved: Marathon, Barrie, Mount Forest, New Vision (Kitchener), Rosedale (Hamilton), Stratford, West End (Ottawa), Solo practitioner (Hamilton)

Highlights:

  • Phase 2 pilot-tested 80 indictors and 335 criteria in three family practices.  Overall, standards were met for 83% of the legal criteria completed, 74% of the essential criteria completed and 64% of the desirable criteria completed.

  • Phase 2 commendable practice changes and improvements included: team behavior and morale; regular practice meetings; Human Resource policies; implementation of Bill 31 and other legal requirements; physical facility improvements; waiting room changes; patient surveys; patient information and handouts; patient access to telephone and appointments; practice audits; infection control; medication management and record keeping.  

  • The seven Phase 3 practices all completed the required chart audits of clinical outcomes and the system audit.  A chart audit training program was developed. Practices also conducted patient satisfaction assessments and staff quality of work life assessments. Chart audit, system audit, patient satisfaction, and staff quality of work life data across practices were summarized and provided back to practices in the form of comparative, anonymous practice profiles reports.

Challenges:

Engage the support and buy-in from the Government, professional organizations, other quality stakeholders and providers towards the collective goal: a province wide Quality assessment program implemented throughout Ontario.