In 2004 and 2005, the General Practice Services Committee (GPSC), a partnership of the BC Medical Association (BCMA) and the Ministry of Health, held province-wide consultations with about 1000 general practitioners (GPs) to hear their perspectives on the decline of family practice. The committee also listened to their ideas about solutions to the mounting problems of low morale and decreasing professional satisfaction among BC’s full-service family practice physicians.
Through these consultations, called Professional Quality Improvement Days (PQIDs), the committee learned that the declining interest in family practice might be curbed if GPs:
- Felt valued.
- Were appropriately compensated for their work.
- Received adequate, ongoing training.
- Were supported to provide high-quality care for an increasingly complex and aging patient population.
The GPSC responded to the request for training and support by establishing the Practice Support Program (PSP) in 2007.
The PSP began as an initiative of the GPSC and now receives additional direction, support, and funding from the Shared Care Committee and the Specialist Services Committee (also partnerships between the BCMA and Ministry of Health).
Specialist physicians now participate in learning modules that are applicable to specialist practices. They are also involved in the development and delivery of learning modules that focus on the shared care of patients between family and specialist physicians.
Program design and structure
The PSP is designed to improve clinical and practice management for physicians and supports them to implement tools and resources in their daily practice that can increase efficiency and capacity, improve patient care and professional satisfaction, and reduce costs to the health care system.
The CME-accredited program offers focused training sessions (learning modules) for physicians and their medical office assistants (MOAs) in three domains:
- Clinical improvement.
- Practice management.
- Information technology.
The PSP uses a quality-improvement approach and the Plan-Do-Study-Act (PDSA) cycle, in which training sessions are interspersed with action periods, during which new learnings are applied to the day-to-day medical practice.
Each PSP learning module involves three half-day group learning sessions, offered locally in communities throughout the province. Each group session is followed by an action period of 6 to 8 weeks during which PSP participants try out what they’ve learned in their own practice. During action periods, participants receive in-practice support to ensure they get as much benefit as possible from the learning sessions, and have the guidance they need to incorporate newly acquired tools and processes into their practices.
Physicians are compensated for attending the learning sessions and for trying small tests of change in their practice during action periods.
Module learning sessions are organized in communities throughout BC by health authority PSP coordinators and are delivered by local health authority regional support teams (each health authority has its own support team).
Regional support teams include PSP provincial coordinators and physician practice leaders; i.e., physicians who have become learning module leaders through participation in train-the-trainer sessions arranged by the PSP provincial coordinating office.
Physicians and MOAs interested in participating in the program can contact the PSP coordinator in their health authority.
In-practice support for participants can be provided in different ways, including:
- Visits from members of local health authority regional support teams.
- In-practice coaching support that meets the needs of a particular physician community.
Participation and results
The PSP is providing valuable new skills and tools to BC physicians and MOAs who participate in the program, particularly in the area of increased practice efficiency. In a recent evaluation of the program, 70% of physicians who participated in the Advanced Access learning module said they had reduced patient wait times for regular appointments and 51% reduced wait times for urgent appointments.1
As of March 2012, nearly 70% of all practising family physicians in BC and more than 1000 MOAs have participated in the program, improving both patient care and their professional satisfaction. In a recent external evaluation of the program, physicians reported that participating in PSP learning modules has had a positive impact on their practices (Advanced Access, 87.7%; Chronic Disease Management, 80.6%, Group Medical Visits, 86.3%).2
PSP tools and resources are enabling physicians to better support patients, as well as helping to reduce wait times, increase professional satisfaction, and lower costs.
Current learning modules
- Advanced Access/Office Efficiency.
- Group Medical Visits (includes Patient Self-management and Health Literacy).
- Chronic Disease Management.
- Adult Mental Health.
- End of Life.
- Child and Youth Mental Health (in development).
- Shared System of Care for patients with COPD/Heart Failure (in development).
- Quarterly learning sessions (in development).