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Phase Three: Field Test

Introduction

Improving the quality of medical care is a key purpose of an accountable public health care system. Family medicine is the cornerstone of the health care system and Family Health Teams (FHTs) play a key role in providing safe, effective, patient-centered, timely, responsive and comprehensive primary health care. There is currently no method for inter-professional team practices to self-assess how effectively they are performing. As our health care system and out patients’ needs increase in complexity, teamwork in primary care becomes even more important. A quality framework that supports team function and development is vital.

Two phases of the Quality in Family Practice project have been completed. In Phase 1, an international literature review/environmental scan, 13 inter-professional focus groups, teleconferences with experts, and site visits to international quality programs informed the development of the Quality inter-professional Assessment Tool and program for use in family practices in Ontario. In Phase 2, three family practices underwent the Quality process in a demonstration pilot project. The Quality project is distinctive in that it strives to facilitate the achievement of quality by all members of the group practice. The Assessment Tool is clearly intended for the “practice team” rather than solely the “family doctor”. Quality is designed to help practice members work together as a team to identify improvements, plan changes and implement actions as part of a continuous quality improvement (CQI) process.

This proposal outlines the next phase in the process of implementing the Quality program in Ontario. The purpose of this field trial is to refine and evaluate the Quality program and Assessment Tools to support FHTs in delivering inter-professional, collaborative quality programs and services to their patients.

Objectives

Seven FHTs will participate in this project. Five FHTs will be newly recruited to Quality. The other two FHTs are the two group practices who participated in the demonstration pilot; they will be going through the assessment for the second time.

The objectives of the Quality field test are:

  1. To refine the Quality program to support FHTs in building capacity to develop and implement effective inter-professional programs and services to address local population needs by: (a) further refining the Quality
  2. To evaluate key areas of the Quality tool identified as most relevant for FHT development. During this process, we will: (a) evaluate the processes of implementation by describing the strategies that FHTs develop to meet their selected indicator requirements; (b) in the two repeat FHTs, evaluate the impact of the program on select patient outcomes, impact on inter-professional team development, and costs of implementation; (c) develop a more rigorous, comprehensive evaluation plan for measuring long-term performance/outcomes indicators, beyond this short-term field test. assessment process, Assessment Tool, website and resources; (b) establishing a network between FHTs to share experiences and best practices.