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Five-year results of the peer assessment program of the College of Physicians and Surgeons of Ontario.

https://arctichealth.org/en/permalink/ahliterature227916
Source
CMAJ. 1990 Dec 1;143(11):1193-9
Publication Type
Article
Date
Dec-1-1990
Author
R G McAuley
W M Paul
G H Morrison
R F Beckett
C H Goldsmith
Author Affiliation
College of Physicians and Surgeons of Ontario, Toronto.
Source
CMAJ. 1990 Dec 1;143(11):1193-9
Date
Dec-1-1990
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Clinical Competence - statistics & numerical data
Data Collection
Family Practice - standards
Humans
Medical Audit - statistics & numerical data
Medical Records - standards
Medicine - standards
Middle Aged
Ontario
Peer Review
Specialization
Abstract
The office practices of 918 physicians selected through stratified random sampling from the College of Physicians and Surgeons of Ontario (CPSO) registry were assessed by peers and the Peer Assessment Committee of the CPSO from 1981 to 1985. The sample comprised 662 general practitioners (GPs) and family physicians (FPs) and 256 specialists in 11 fields. Of the physicians 749 (82%) had neither deficient records nor an unsatisfactory level of patient care. Of the GPs and FPs 97 (15%) had serious deficiencies in one or both areas, as compared with 4 (2%) of the specialists (p2 less than 0.00001). The proportions of certificants of the Royal College of Physicians and Surgeons of Canada and of the College of Family Physicians of Canada (CFPC) with serious deficiencies were low (2% and 3% respectively). Three statistically significant predictors of physician performance were found among the GPs and FPs: age, CFPC membership status and type of practice. Of the 56 physicians who were reassessed 6 to 12 months later 29 (52%) had made the improvements recommended by the committee. Our findings demonstrate the need, feasibility and acceptance of a peer assessment program of office practices in Ontario.
Notes
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PubMed ID
2224696 View in PubMed
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Observer variation in an audit of charts of patients with rheumatoid arthritis.

https://arctichealth.org/en/permalink/ahliterature221880
Source
Physiother Can. 1992;44(2):26-32
Publication Type
Article
Date
1992
Author
F V Wright
A. Helewa
C H Goldsmith
N. Doshi
Author Affiliation
Hugh MacMillan Rehabilitation Centre, Toronto, ON.
Source
Physiother Can. 1992;44(2):26-32
Date
1992
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Arthritis - therapy
Data Collection
Home Care Services - standards
Humans
Medical Audit - methods
Medical Records - standards - statistics & numerical data
Medical Records, Problem-Oriented - standards - statistics & numerical data
Observer Variation
Ontario
Physical Therapy Modalities - standards
Reproducibility of Results
Abstract
Arthritis Society physiotherapists (PTs) in Ontario adopted Problem Oriented Records (POR) to monitor patient care; goals were to encourage patient specific treatment plans and standardized records. After nine months in practice, the POR system was evaluated by an audit on charts of patients with Rheumatoid Arthritis. Audit teams of two PTs were created within each of five geographic areas. Auditors attended an audit instruction workshop. Two charts, selected randomly from the discharged patients of each of 38 therapists, were independently scored on 56 items by an audit team. The extent of agreement within the auditor team (observer variation) was measured, and adequacy scores computed for each chart. Adequate reliability of the audit instrument was established before examination of adequacy scores and making inferences about quality of care. The auditor agreement measures (kappa) varied from 0.13 to 0.97, mean = 0.74 and SD = 0.16; these estimates were indicative of adequate reliability of the audit form, although agreement scores were different amongst the five areas (P2 less than .01). POR adequacy scores varied from 10.0 to 93.1, mean = 64.5 and SD = 16.9. There were no differences in adequacy scores amongst the five areas (P2 = .61). To reduce observer variation, increased pre-audit emphasis is needed on auditor guidelines and training for items relating to assessment findings, problem identification, and treatment planning.
PubMed ID
10119257 View in PubMed
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