The assessment of poorly performing doctors: the development of the assessment programmes for the General Medical Council’s Performance Procedures

Southgate, Lesley; Cox, Jim; David, Timothy; Hatch, D. J.; Howes, Alan D; Johnson, Neil; Jolly, Brian; Macdonald, Ewan; McAvoy, Pauline; McCrorie, Peter; Turner, Joanne

doi:10.1046/j.1365-2923.2001.00001.x

Cited by 36 publications

(31 citation statements)

References 19 publications

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“…It is argued that there is limited reliability in the peer review of care (Bernstein et al 1997;Dauphinee & Blackmore 2001;Evans, Leeson & Petrie 2007;Smith et al 1997;Watterson et al 2011). Reliability issues also arise when considering assessments of quality and appropriateness of care, as they require professional opinions combined with the interpretation of valid relevant external evidence (Gibbons & Downes 1998;Humphrey-Murto et al 2005;Jörg et al 2002;Southgate et al 2001). Similarly, reliability in the accreditation of organisations is discussed amongst stakeholders (Braithwaite et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Researching the Reliability of Accreditation Survey Teams: Lessons Learnt When Things Went Awry

Greenfield

Pawsey

Naylor

et al. 2013

HIM J

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Accreditation of health organisations, occurring in over 70 countries, is predicated upon the reliability of survey teams judgements, but we do not know the extent to which survey teams are reliable. To contribute evidence to this issue, we investigated the reliability of two survey teams simultaneously assessing an organisation. The setting was a large Australian teaching hospital, and data were derived from interviews, observations and survey documents. Participants were from four groups: hospital staff, accreditation agency personnel and surveyors, and research staff. Thematic analysis was employed to identify significant factors that influenced the study. The two survey teams ratings and recommendations demonstrated high levels of agreement. However, while a common understanding of the study existed, the research was compromised. There were difficulties enacting the study. Contrary to negotiated arrangements, the pressure of the study resulted in surveyors discussing evidence and their interpretation of standards. Uncontrollable circumstances (late changes of personnel), and unexpected events (a breakdown of working relationships), challenged the study. The twin lessons learnt are that a consistent survey outcome is likely to be reached when reliability of process and consistent application of standards are pursued, and research requires negotiating challenges and relationships.

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Section: Introductionmentioning

confidence: 99%

Researching the Reliability of Accreditation Survey Teams: Lessons Learnt When Things Went Awry

Greenfield

Pawsey

Naylor

et al. 2013

HIM J

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“…The term used by the RPSGB is 'deficient professional performance', defined as: "professional performance which falls below the standards or competencies that may reasonably be expected of a pharmacist or pharmacy technician practising in a particular field or speciality" [11]. In the wider healthcare community, performance concerns are labelled differently, with terms such as 'poor performance' [9], 'under performance' [12], 'seriously deficient performance' [13,14], 'deficient professional performance' [11,15], and 'cause for concern' [16] common.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing pharmacist performance: A review of the peer-reviewed literature

Schafheutle¹,

Seston²,

Hassell³

2011

Health Policy

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“…New approaches to quality improvement have resulted, as have initiatives focusing on identifying and assessing poor performance 7 – 9…”

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confidence: 99%

Multisource feedback: a method of assessing surgical practice

Violato

Lockyer

Fidler

2003

BMJ

147

161

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New methods are needed for assessing surgeons' performance across a wide range of competencies. Violato and colleagues describe the development of a programme based on feedback from medical colleagues, coworkers, and patients for the assessment of surgeons throughout Alberta, CanadaThe assessment and maintenance of competence of physicians has received worldwide attention, 1-4 partly in response to concerns about poor performance by physicians and the safety of patients 5 6 and partly as a result of demands for accountability to patients and funding agencies. 2-4New approaches to quality improvement have resulted, as have initiatives focusing on identifying and assessing poor performance. [7][8][9] Throughout the Western world, thinking about competence has shifted. Medical expertise and clinical decision making are increasingly recognised as only components of competence. Communication skills, interpersonal skills, collegiality, professionalism, and a demonstrated ability to continuously improve must also be considered when assessing physicians.2-4 7 8 10 11Multisource feedback, using questionnaire data from patients, medical colleagues, and coworkers, is gaining acceptance and credibility as a means of providing primary care physicians with quality improvement data as part of an overall strategy of maintaining competence and certification.1 7 8 Work with Canadian, American, and Scottish generalist physicians shows that this method is reliable, valid, and feasible.7 8 12-15 Research in both industry and medicine shows that multisource feedback systems (or 360°f eedback) can result in individual improvement and the adoption of new practices.12 [16][17][18] The College of Physicians and Surgeons of Alberta, the statutory medical registration body for the province of Alberta, adopted a performance appraisal or multisource feedback system for all physicians in its jurisdiction-the physician achievement review program. This system focuses on quality improvement and operates entirely separately from the complaints and disciplinary procedures. Medical colleagues, coworkers (for example, nurses, pharmacists, and psychologists), patients, and the physician (self) all provide survey based data, which are summarised by item and category and compared with the physician's specialty group. The instruments for family physicians were psychometrically tested and adopted.7 8 19 As part of its overall goal of ensuring that all physicians in the province participate in a multisource feedback process every five years, the college asked a committee of surgeons and social scientists to design and test instruments that could be used for the surgical specialties. This paper describes the development and evaluation of a multisource feedback system for surgeons designed to assess a broad range of competencies.

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The assessment of poorly performing doctors: the development of the assessment programmes for the General Medical Council’s Performance Procedures

Cited by 36 publications

References 19 publications

Researching the Reliability of Accreditation Survey Teams: Lessons Learnt When Things Went Awry

Researching the Reliability of Accreditation Survey Teams: Lessons Learnt When Things Went Awry

Factors influencing pharmacist performance: A review of the peer-reviewed literature

Multisource feedback: a method of assessing surgical practice

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