Location of Innovation:
British Columbia
Description of Innovation:
In Canada, debate about reforming health care is driven by delayed access to specialists and procedures. Enhancing specialist intervention is not, however, the key to health care improvement. Countries with better primary care have better population health outcomes and lower health care costs, and the World Health Organization released a report in 2008 urging that primary health care be prioritized.(1,2)
Access to family physicians is inadequate in BC, as it is in all provinces. The perceived demands and complexity of full-service practice may promote family physician sub-specialization and employment in walk-in clinics. Alarmed by the trend away from full-service family practice, leaders in BC established the General Practice Services Committee (GPSC) with representatives from the Ministry of Health Services and the BC Medical Association (BCMA). The GPSC undertook consultations with generalists in 2004 which informed development of programs that aim to improve physician and patient satisfaction and to promote full-service family practice. The Practice Support Program (PSP) is administered by five practice support teams located throughout the province. Several elements are available; physicians may participate in any or all:
• Advanced access booking
• Patient self management
• Group medical visits
• Chronic disease management
• Quality improvement
• Mental health screening and interventions
The PSP (www.practicesupportbc.ca) offers a variety of means and incentives for physicians to incorporate new approaches:
• A practice assessment questionnaire
• Expanding the role of the medical office assistant (MOA)
• Peer-group learning sessions
• Online learning modules
• MAINPRO credits from the College of family Physicians of Canada
• Financial compensation for physicians and MOAs for training sessions
As of December, 2009, 1,047 physicians had completed at least one PSP module.
Population:
All
Outcome measures:
- Advanced access booking
- Patient self management
- Group medical visits
- Chronic disease management
- Quality improvement
- Mental health screening and interventions
Evidence of success:
The BC Medical Journal published an evaluation of the PSP in November, 2009.(3) Participants, both physicians and MOAs, were given surveys upon completion of learning sessions. The response rate was low (21-26%). The great majority of responders had a favourable impression of the impact of learning modules on physician practice and patient satisfaction. The report also included a survey of 21 physicians who did not participate, and half indicated they had already incorporated the some of the PSP approaches into their practice. More research is necessary to determine the impact and efficacy of the PSP on primary care in BC. According to Liza Kallstrom of the BCMA, investigators at UBC are applying for funding to conduct research on the prevalence of treatment and clinical outcomes for physicians who have completed the mental health module. She said that they have preliminary evidence of improvements in Personal Health Questionnaire depression scale scores among patients.
Website link:
www.practicesupportbc.ca
Supporting literature (if any):
References 1. Starfield, B. Toward international primary care reform. CMAJ. 2009;180(11):1091-1092. 2. World Health Organization. The world health report 2008: Primary health care: Now more than ever. Geneva (Switzerland): WHO; 2008. 3. MacCarthy D, Kaallstrom L, Gray R, Miller J, Hollander MJ. Supporting family physicians in British Columbia: The experience of the Practice Support Program. BCMJ. 2009;51(9):394-397.
Your Name:
Dr. Randall White |
