Family physician practice visits arising from the Alberta Physician Achievement Review

Abstract

BackgroundLicensed physicians in Alberta are required to participate in the Physician Achievement Review (PAR) program every 5 years, comprising multi-source feedback questionnaires with confidential feedback, and practice visits for a minority of physicians. We wished to identify and classify issues requiring change or improvement from the family practice visits, and the responses to advice.MethodsRetrospective analysis of narrative practice visit reports data using a mixed methods design to study records of visits to 51 family physicians and general practitioners who participated in PAR during the period 2010 to 2011, and whose ratings in one or more major assessment domains were significantly lower than their peer group.ResultsReports from visits to the practices of family physicians and general practitioners confirmed opportunities for change and improvement, with two main groupings – practice environment and physician performance. For 40/51 physicians (78%) suggested actions were discussed with physicians and changes were confirmed. Areas of particular concern included problems arising from practice isolation and diagnostic conclusions being reached with incomplete clinical evidence.ConclusionThis study provides additional evidence for the construct validity of a regulatory authority educational program in which multi-source performance feedback identifies areas for practice quality improvement, and change is encouraged by supplementary contact for selected physicians.

Clinical practice visits: a rapid review

“…A total of nine publications (reporting outcomes for eight studies) provided the evidence base for this rapid review. [5][6][7][8][9][10][11][12][13] Records identified through: PubMed n = 8,491 York CRD n = 965 Cochrane Library n = 1,766 Total n = 11,222…”

“…Of the nine articles that met the inclusion criteria for this rapid review; there were six observational studies, [5][6][7]9,10,13 one longitudinal study 8 and two publications reporting outcomes for the same RCT. 11,12 Eight studies provided information for research question one.…”

“…11,12 Eight studies provided information for research question one. [5][6][7][8][9][11][12][13] The same group of seven studies provided information for research questions three and four. 5,6,[9][10][11][12][13] None of the included studies provided information for research question two.…”

“…The evidence base consisted of outcomes from approximately 650 visits (one study did not report the number of visits it undertook 10 ). Visits were conducted by healthcare providers from general practice (five study groups 7,8,[10][11][12][13] ), psychiatry (one study group 9 ), allied health (one study group 6 ) and paediatric anaesthetics (one study group 5 ). None of the included studies carried out practice visits in a surgical setting.…”

“…None of the included studies carried out practice visits in a surgical setting. Three of the included studies were conducted in Australia, 9,10,13 two in the Netherlands, 6,11,12 two in Canada 7,8 and one in the United Kingdom. 5…”