McMaster University

McMaster University

Faculty of
Health Sciences

How good is your family practice?

Published: February 27, 2009
Cheryl Levitt
Dr. Cheryl Levitt, a professor in the department of family medicine in the Michael G. DeGroote School of Medicine and past president of the Ontario College of Family Physicians.

Assessment tools developed for MDs

Every patient trusts their family doctor to run a safe and efficient medical practice.

To ensure this happens, researchers in McMaster University’s Department of Family Medicine have developed a program which assesses a family practice’s quality of care and provides service improvement suggestions.

Ontario’s Ministry of Health and Long-Term Care funded the project to recommend a quality improvement program for the province. Current programs studied included those in Australia, New Zealand, Britain, Europe and the United States.

Dr. Cheryl Levitt, a professor in the department of family medicine in the Michael G. DeGroote School of Medicine and past president of the Ontario College of Family Physicians, is project leader of the Quality in Family Practice program.

The program promotes a self-assessed, voluntary model of quality assessment for family practices.  Doctors, nurses and administrators learn how to rate themselves and their practice, decide what their priorities are and then work with the project’s advisers to make changes, prior to a formal external assessment.

Dr. Levitt said these changes could range from something as simple as safely storing prescription pads under lock and key or eliminating mercury-based blood pressure monitors in a doctor’s office, to establishing a tracking system to follow patients admitted to hospital and those with high blood pressure or setting up an eco-friendly office.

The assessment tool features more than 80 quality indicators which are divided into five sections: Factors affecting patients (such as respecting patient rights to formally complain); physical factors (appropriate disinfection and sterilization facilities); clinical practice systems (use of evidence-based clinical practice guidelines); practice and patient informational management (appropriate medical record-keeping); continuous quality improvement and professional development and quality of work life (providing a range of educational resources and materials for members of the medical practice).

Initially, McMaster researchers tested the new tool on two large group family practices in Mount Forest and Kitchener-Waterloo and a solo practice in Hamilton. It was followed by further testing in seven family health teams throughout Ontario.

"It was extremely well received," Dr. Levitt said.

Ultimately, Dr. Levitt said, the hope is to develop a program that could be used to assess the quality of family practices across Canada.  "We would like to establish provincial and, eventually, national programs where family practices voluntarily agree to be assessed by a panel of peer experts to ensure standards meet government, public and professional expectations."

A special week entitled Celebrate Quality Internationally and in Ontario (CQIO) is planned for March 2 to 6 in Toronto where initiatives to improve primary care/family practice will be highlighted.

McMaster’s Quality in Family Practice Team will convene a weeklong program of events on quality improvement that also includes international speakers: Dr. Joachim Szecsenyi, director, general practice and health services research, Heidelberg University, Germany; Dr. Jim Vause, who has led the development of national quality assessment guidelines in primary care and cancer care in New Zealand; Ruth Vause, a leader in New Zealand’s Practice Manager’s Association; and Ian Watts, general manager, Royal Australian College of General Practice.

Web: Quality in Family Practice

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