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Research ArticleResearch

“My approach to this job is ... one person at a time”

Perceived discordance between population-level quality targets and patient-centred care

Noah Ivers, Jan Barnsley, Ross Upshur, Karen Tu, Baiju Shah, Jeremy Grimshaw and Merrick Zwarenstein
Canadian Family Physician March 2014; 60 (3) 258-266;
Noah Ivers
Family physician at Women’s College Hospital in Toronto, Ont.
MD CCFP
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  • For correspondence: noah.ivers@utoronto.ca
Jan Barnsley
Associate Professor at the Institute for Health Policy Management and Evaluation at the University of Toronto.
PhD
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Ross Upshur
Canada Research Chair in Primary Care Research and Professor in the Department of Family and Community Medicine at the University of Toronto.
MD MSc CCFP FRCPC
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Karen Tu
Family physician in the University Health Network, Scientist at the Institute for Clinical Evaluative Sciences (ICES), and Assistant Professor in the Department of Family and Community Medicine at the University of Toronto.
MD MSc
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Baiju Shah
Endocrinologist at Sunnybrook Health Sciences Centre, Scientist at ICES, and Assistant Professor in the Department of Medicine at the University of Toronto.
MD PhD FRCPC
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Jeremy Grimshaw
Senior Scientist in Clinical Epidemiology at the Ottawa Hospital Research Institute in Ontario and Canada Research Chair in Health Knowledge Transfer and Uptake.
MB BCh PhD
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Merrick Zwarenstein
Senior Scientist at ICES and Director of the Centre for Studies in Family Medicine at the University of Western Ontario in London.
MB BCh PhD
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    Table 1.

    Characteristics of the 54 potential participants and of the 12 participants selected for interviews

    CHARACTERISTICINTERVIEW PARTICIPANTS, N (%)TRIAL PARTICIPANTS, N (%)
    Sex
      • Male8 (67)30 (56)
      • Female4 (33)24 (44)
    Years in practice
      • 3–103 (25)14 (26)
      • 11–254 (33)18 (33)
      • > 255 (42)22 (41)
    Location
      • Rural7 (58)26 (48)
      • Urban5 (42)28 (52)
    Practice size
      • < 600 patients2 (17)15 (28)
      • 600–1000 patients4 (33)18 (33)
      • > 1000 patients6 (50)21 (39)
    • View popup
    Table 2.

    Selected barriers and suggested areas for future research when conducting audit and feedback for quality improvement in primary care

    BARRIERS IDENTIFIEDAREAS FOR FUTURE RESEARCH
    Discordance between patient-centred ideals and quality improvement goalsHolistic measures of quality covering all domains—effectiveness measures must have patient-level data
    Competing priorities and goal conflictProvide data for areas of high priority and focus on improvement for higher-risk patients
    Lack of technical expertise or human resources dedicated to quality improvementExternal support to manage data and support quality improvement activities while developing in-house capacity

Additional Files

  • Tables
  • CFPlus Additional Information

    This data supplement contains sample feedback reports.

    Files in this Data Supplement:

    • Adobe PDF - Feedback_Report_1.pdf
    • Adobe PDF - Feedback_Report_2.pdf
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Canadian Family Physician: 60 (3)
Canadian Family Physician
Vol. 60, Issue 3
1 Mar 2014
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“My approach to this job is ... one person at a time”
Noah Ivers, Jan Barnsley, Ross Upshur, Karen Tu, Baiju Shah, Jeremy Grimshaw, Merrick Zwarenstein
Canadian Family Physician Mar 2014, 60 (3) 258-266;

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“My approach to this job is ... one person at a time”
Noah Ivers, Jan Barnsley, Ross Upshur, Karen Tu, Baiju Shah, Jeremy Grimshaw, Merrick Zwarenstein
Canadian Family Physician Mar 2014, 60 (3) 258-266;
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