INDIVIDUAL PRACTICE REVIEW

Quality in Practice

TARGETED SUPPORT   |   TOOLS   |   RESOURCES   |   FAQS

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“We bring options to physicians, and help them choose solutions that are sensible, reasonable, practical, doable.”Dr. Nigel Flook, CPSA Senior Medical Advisor

INDIVIDUAL PRACTICE REVIEW (IPR)

Individual Practice Review (IPR) provides members with timely, relevant feedback about their practices to inform quality improvement.

An IPR emphasizes targeted support and education to best help physicians grow good practice. When a physician is selected or referred, we work together to develop the most effective support plan.

We offer trained assessors led by an experienced clinical team, supported by independent expertise when necessary to meet individual physician needs. Our assessors are peer physicians who use the R2C2 feedback model to help physicians reflect on their practice and identify opportunities to improve.

All physician participants will be eligible for Continuing Professional Development (CPD) credits through the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada.

Member participation in Continuing Competence programs is confidential under sections 52 and 53 of the Health Professions Act.

Individual Practice Review (IPR) Provides Timely, Relevant Feedback To Benefit Both Physicians And Patients

TARGETED SUPPORT TO MEET INDIVIDUAL NEEDS

Your IPR may involve any of the following competency assessment options (click the tabs to learn more). Let us know if we can connect you with tools and resources that can help you offer safe, effective care to your patients.

A review of key administrative processes; recordkeeping and chart-stimulated recall conducted by a trained peer physician (practice visitor). Can take place in a variety of practice locations.

What to Expect:

  • A practice visitor will attend the selected practice location for approximately 4 to 5 hours.
  • During this time, the practice visitor will tour the practice location, interview administrative staff, review practice processes and review between 15 to 25 patient records.
  • The practice visitor will select 4 to 5 patient records for discussion with the participating physician.
  • The practice visitor will require a private place to work and the participating physician will be asked to remain available throughout the scheduled visit.
  • The practice visitor will discuss findings with the physician throughout the visit, and follow up with a final report that provides feedback about the practice and identifies potential areas for practice improvement.
Offers participants feedback through the Medical Council of Canada’s MCC 360 survey tool, where colleagues, coworkers and patients provide a comprehensive look at the role of the physician as communicator, collaborator and professional. Participants also receive other practice-specific information with their MSF+ results, such as prescribing data.

Each physician participating in MSF+ will meet with a trained CPSA Physician Facilitator. The facilitator will discuss the assessment results, assist in identifying practice improvement opportunities and offer information and resources that support quality improvement. *

Participant Selection

  • 500 Family/General Practitioners will be randomly selected in 2017, with Specialist physicians participating in 2018.
  • The data and feedback gathered will be used to further refine IPR processes, tools and resources.
  • Additional participants will be referred from other College programs.
  • In future, Practice Checkup data will be used in the selection process.

*Using the R2C2 facilitation model.

For more information:

Phone: 780-969-4986 or 1-800-561-3899 Ext. 4986 | Email: CC.inquiries@cpsa.ab.ca

Focused data review (e.g., billing information, prescribing profiles, etc.) which profiles individual data against normative peer groups.

What to Expect:

  • Data profiles are compiled by IPR staff.
  • Participating physicians are asked to complete a questionnaire providing an overview of their practice.
  • The completed questionnaire and the practice data profile are reviewed by the assigned Senior Medical Advisor (SMA).
  • In discussion with the participating physician, the SMA designs the practice assessment based on the practice overview and data profile.

Review of practice processes such as health screening, chronic disease management and recordkeeping by a trained peer physician (practice visitor). Includes recommendations for how the physician can enhance EMR use to align with the CPSA Standards of Practice.

What to Expect:

  • The participating physician will be asked to arrange remote access to the EMR for the assigned practice visitor for a defined period of time.
  • The practice visitor will select and review approximately 20- 25 records during this time frame.
  • The participating physician will receive a report with feedback about use of the EMR, documentation practices and patient care, identifying potential areas for practice improvement.

Observation of patient interactions (with consent) in a variety of practice locations.

What to Expect:

  • The participating physician may be observed providing patient care in his or her clinic, surgical suite, emergency room, etc.
  • The time frame for direct observation is typically 1 to 2 days, but will vary depending on the reason for the assessment, location and clinical service being observed.
  • The direct observation will be conducted by a peer physician selected and approved by the Senior Medical Advisor and the participating physician.
  • The participating physician will receive a report with feedback about his or her practice in relation to the observation.

On-site review of practice processes, health screening and chronic disease management according to best practice guidelines.

What to Expect:

  • In advance of the visit, the participating physician will be asked to identify a specified number of patients that fit into defined categories (e.g., females over the age of 50; patients with diabetes; males over age 50, etc.)
  • For clinics that use paper records, the physician will be asked to have the charts of patients in the specified categories pulled in preparation for the visit.
  • A nurse reviewer will attend the practice location for approximately 7 to 8 hours.
  • The nurse reviewer will require a private place to work and the participating physician will be asked to remain available intermittently throughout the scheduled visit. The physician will be able to maintain a standard patient schedule, but may be required to meet with the nurse reviewer to discuss specific patients between scheduled appointments.
  • Selecting patient records from the provided lists or pulled patient records, the nurse reviewer will go through 70 to 100 patient records looking for alignment with health screening, chronic disease management and the CPSA Standards of Practice.
  • The participating physician will receive a final report with feedback about his or her practice in relation to guidelines for health screening and chronic disease management, administrative processes for handling DI/lab results and general observations regarding recordkeeping.

FREQUENTLY ASKED QUESTIONS

Yes, regulated members are mandated by the Health Professions Act to complete a quality improvement initiative at least every five years.

This includes the Practice Checkup for all physicians, and Individual Practice Review (IPR) and Group Practice Review (GPR) for selected or referred physicians. Rules for Member Participation

You will be referred to the College’s Deputy Registrar to discuss alternatives.

The IPR is designed around each physician’s practice and the reason for the referral. The process will look like this:

  1. Referral to IPR. You will receive correspondence from IPR indicating that you have been referred for an Individual Practice Review. The correspondence will note you will be responsible for associated costs, that you are welcome to retain legal counsel throughout the process; a copy of the “Continuing Competence Rules” will be provided.
  2. Questionnaire/Conflict of Interest: You will be asked to complete a questionnaire to help IPR understand your practice (e.g., number of physicians in the practice, years in operation, electronic or paper patient records, services offered etc.). You will also be asked to complete a Conflict of Interest form to assist in the selection of trained physicians (practice visitors) to carry out assessment activities.
  3. Practice Profile. A practice profile will be prepared by IPR, combining information obtained from your completed questionnaire, Alberta Health Care billing information, MD Snapshot reports (prescribing information), and complaint history. The practice profile helps determine who will be your assigned CPSA Senior Medical Advisor (SMA), and is used to develop/customize the assessment process.
  4. Senior Medical Advisor. The assigned SMA will provide oversight and customize the process as indicated. You will have an initial teleconference (approximately 1 hour in length) or an in-person meeting with the SMA to discuss your practice and reason for the referral, to develop an assessment strategy and determine next steps. Legal counsel is welcome to be part of any phone calls between the participating physician and the SMA.
  5. Practice Assessment. Your will undergo a practice assessment. The type of assessment will be determined by the SMA based on specific features of your practice and the reason for referral. The most common practice assessment is an onsite visit by a trained assessor at one or more locations where you practice.
  6. Assessment Report. You will receive a confidential report outlining your commendable attributes/processes, as well as areas where improvement opportunities are indicated. A phone call or in-person meeting between you and the SMA will be arranged to discuss the report findings and determine how you will begin to implement the recommendations.
  7. Implement Practice Improvements. With guidance from the SMA, you will be provided with tools and strategies to implement any changes recommended in the assessment report.
  8. Practice Reassessment (if indicated) or Close IPR File. Once you have had an opportunity to implement any recommended changes, the SMA will determine if further assessment is required or if the file can be closed. Reassessment is common when a large number of practice improvements are identified in the assessment report. An onsite practice visit or remote chart review are commonly used for reassessment.
 

PAR was discontinued in 2016 and is no longer a requirement for Alberta physicians.*

The College’s new MSF+ process is one of the competency assessment options available for physicians referred or selected for Individual Practice Review (IPR).

A component of MSF+ is MCC360, developed by the Medical Council of Canada. The MCC360 requirements and process may feel like the PAR process, but the tools are newly developed practice feedback surveys with new questions and new criteria. As part of MSF+, MCC360 provides physicians involved in IPR the opportunity to engage in a self-assessment process to reflect on their roles as collaborator, communicator and professional.

Every Alberta physician who completes MSF+ will receive facilitation from a peer to explore practice improvement strategies based on feedback data.

*See Practice Checkup for information on the College’s new general assessment process.

Member participation in Continuing Competence programs is confidential under sections 52 and 53 of the Health Professions Act.


WE CAN HELP

Individual Practice Review

Phone: 780-969-5023 or 1-800-561-3899 Ext. 5023  | Email: CC.inquiries@cpsa.ab.ca