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The refinement of the Quality Tool using a Delphi Panel

Sponsor: Ontario Ministry of Health and Long Term Care

The Quality Tool provides a framework for CQI and assessment of comprehensive indicators and criteria for standards of excellence in family practice.  The tool is used to implement the practice self-assessment process and the external assessment by the Assessors. It assesses whether family practices meet practice guidelines and quality standards that are established and expected in family practices. The Quality tool incorporates the key areas for accessible, safe, effective family practice care: needs and rights of patients, access, patient-centredness, physical factors, medical equipment, clinical practice systems, information management, human resources, medical records, continuity of care, continuing professional development, and quality of work life.  The Quality Tool consists of 80 indicators and 335 criteria. Pilot testing suggested that refinement of the tool could promote uptake in family practice.

Further to completion of Phase 3 in 2008, a Delphi Study was initiated to fine-tune the indicators / tool. The Delphi Panel included 23 experts from Ontario, each with varying experience with the Quality Tool.

Prior to the initiation of the Delphi Panel, the Revising the Quality Tool Research Team embarked on a validation exercise by comparing the Quality Tool with 3 other existing quality tools: 1) European Practice Assessment (EPA); 2) Quality and Outcomes Framework from the UK; and 3) CIHI Pan-Canadian Indicators for Primary Care. This comparison resulted in 63 indicators being brought forth to the Delphi Panel for consideration regarding whether these indicators should be included in the revised Quality Tool.

A number of review sessions and surveys were conducted, where the Delphi panel rated each indicator based on whether it was: value-added; measurable; a standard; and important. Following the application of inclusion and exclusion limits, the Quality Tool is being revised into appropriate categories. 

Delphi Panel meeting on March 6, 2009

As part of the Celebrating Quality Internationally and in Ontario (CQIO) Event,
the Delphi Panel met on March 6, 2009 to complete the following tasks:

  1. Vote on remaining indicators regarding inclusion in the Quality Tool
  2. Provide feedback regarding revised categories of the Quality Tool
  3. Provide feedback about participation in the Delphi Process

It is expected that the Delphi process will be competed by the June 2009 and a revised Quality Tool available by August 2009.

Contact personnel:
Research coordinator
:   Kalpana Nair
Investigators:    Lisa Dolovich; Cheryl Levitt; David Price