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1. OVERVIEW OF THE PRACTICE ENHANCEMENT PROGRAM

The Saskatchewan Medical Association (SMA) and the College of Physicians

and Surgeons met in May of 1994 and were in agreement to jointly advance

the establishment of a working group to develop a Practice Assessment and

Enhancement Program in Saskatchewan. The first meeting was held August of

1994 with representatives from both the SMA and the College of Physicians and

Surgeons of Saskatchewan. The committee studied existing programs in other

provinces in order to develop a program which would offer the physicians of

Saskatchewan a positive means of assessing their practice.

The fundamental purpose of the program is educational and thus has become

known as the Practice Enhancement Program (PEP). The program is based on the

assumption that an experienced physician can review another physician’s office

facilities, procedures and medical records to determine the quality of care being

provided by that physician. Patient Questionnaires are also used to ascertain

the patient’s perspective of the quality of care provided by the physician. As

assessments are completed and specific needs for enhancement are observed, the

Practice Enhancement Program will work to offer educational resources to improve

the skills in specific areas.

Fifteen pilot assessments were carried out on volunteer practices in 1996 by PEP

committee members to test and fine tune the assessment tools. The cost of each

visit was approximately $1500 consisting of the honorarium paid to two assessors

and the travelling expenses of the assessors, plus the cost of the Committee

meetings.

In March of 1996 an office was set up for the Practice Enhancement Program in the

Continuing Medical Education department of the College of Medicine, University of

Saskatchewan. The program is administered by a committee of six Saskatchewan

Physicians and staffed by a Coordinator and Program Assistant.

The Practice Enhancement Program now brings the opportunity for office

assessments to randomly selected physicians throughout Saskatchewan. As

feedback is received from these assessments, the Program will continue to improve

and develop in the area of educational enhancement.

The program is funded jointly by the Saskatchewan Ministry of Health, the

Saskatchewan Medical Association and the College of Physicians and Surgeons of

Saskatchewan.

Ontario and British Columbia have found that 78-80% of the physicians assessed,

or 4 out of 5 physicians, have no significant deficiencies in either their medical

records or their quality of patient care. 15% of the physicians assessed had

deficient medical records but no indication of deficient quality of care, 7% had

medical records so deficient that the quality of care could not be determined or

there was concern about the quality of care. British Columbia further reports

that physicians do improve when they are given specific information identifying

deficiencies and advice on how to correct them.