Where do you begin?
Improving quality in family practice can be daunting:
- How do you get started?
- How do you prioritize all the things you want to improve?
- Are you sure you are doing everything you can to facilitate the process?
- Do you ever worry about missing reports or test results?
- Are you as good as you think you are in immunization?
- Do you know how to conduct an audit of your practice?
- Do you know how to seek feedback from your patients?
McMaster University and the Ontario College of Family Physicians have developed, tested, refined, validated and revised a comprehensive set of quality and safety performance indicators to assess a family practice in Canada that was available in the 2010 edition of the Quality Book of Tools; it is part of an interdisciplinary, voluntary assessment Quality program.
Indicators from New Zealand’s Aiming for Excellence, Australia’s Standards for General Practice; the European Practice Assessment, the UK Quality and Outcomes Framework, and the Canadian Institute of Health Information’s Pan Canadian Indicators were compared with the Quality Tool (Healthcare Quarterly 2013;16(1):39-45).
The 'orphan' indicators were validated through a Delphi process involving primary care and quality experts in Canada. The results are incorporated into the new book.
Five Guiding Principles
- Patient/consumer involvement
- Interdisciplinary teams
- Continuous quality improvement (CQI)
Eight new categories, 6 based on the Institute of Medicine aims for the 21st century (safe, effective, patient-centered, timely, efficient and equitable) and 2 based on the Ontario Health Quality Council’s reporting framework attributes of a high performing health system (appropriate resources, integrated) form the backbone of the Tool.
A total of 70 indicators with associated defining criteria and a further information section with helpful web linked tools complete the Tool.
Cheryl Levitt (Professor & Family Doctor) and Linda Hilts (Assistant Professor & Registered Nurse) of McMaster University, Canada, with involvement of the Ontario College of Family Physicians, have published a book called Quality in family practice Book of Tools.
The book is available free for download or purchase at http://qualitybookoftools.ca and is a comprehensive set of practice management and clinical indicators for use in family practices.
The authors are working on a set of teaching modules for Getting Started with quality in family practice.
These modules will help become available over the next year, so stay tuned.