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Peer Redesign Update
One step closer to implementation
 In our last update, we told you about the positive feedback we received from physicians who reviewed the redesigned assessment tools for the walk-in clinic, hospitalists, GP-psychotherapists and dermatology disciplines. External review of the redesigned tools for general practice and family medicine, cardiology, emergency medicine and psychiatry is taking place this fall.
The external feedback already received is now being incorporated into the peer redesign handbooks for each discipline. Handbooks for walk-in clinic and GP-psychotherapy are the first disciplines ready for the next step: using the tools in assessments. As handbooks for each discipline are finalized, they will be used in a limited number of peer assessments so that we can identify any challenges experienced by assessors using peer redesign tools and procedures.
Assessors will be notified when redesigned tools are ready for broad use in all future peer assessments. To ease the transition, the first assessments to be conducted using the finalized peer redesign tools will be restricted to random assessments (as opposed to age-targeted).
We’ll notify you when your discipline changes over to the new tools. When the redesigned tools are ready, transition to using them for all your assessments will take several months. However, if for any reason, you are uncertain of the type of tools you should be using for your assessments, please talk to your assessment coordinator or review the Assessment Report Checklist in your assessment packages.
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News from the Quality Management Partnership
QMP Reports Orientation
 The Quality Management Partnership has been working steadily to implement quality management programs (QMPs) for colonoscopy, mammography and pathology. One of the key components of QMPs is reporting – regular provider, facility, regional and provincial reports that will provide information on quality indicators. This fall, the Quality Management Partnership will issue reports for the colonoscopy, mammography and pathology QMPs.
In anticipation of the first reports being issued, the Partnership is hosting a series of webcasts that will provide participants with an opportunity to learn about:
- The purpose and content of QMP reports
- How to read and interpret the reports
- The role of QMP Facility Leads and Administrative Contacts with respect to QMP reports
- Report timelines
Assessors may be interested in these webcasts as they will help to familiarize you with QMP reports you may encounter during inspections and assessments.
Webcast dates:
Colonoscopy: October 13, 6 to 7 p.m. EST
Pathology: November 1, 4 to 5 p.m. EST
Mammography: November 16, 4 to 5 p.m. EST
Registration details are available on the OHA website in the Event Calendar, under the education tab.
Quality Improvement Resources for Endoscopy Facilities and Providers
As part of its early quality initiatives, the Partnership has produced four quality improvement resources for colonoscopy services in hospitals and out-of-hospital premises. The resources available include:
These guidelines will be useful to GI/endoscopy and general surgery assessors and out-of-hospital premises assessors as a quality improvement resource during assessments and when conducting post-assessment/inspection interviews or follow-ups.
Please take the time to review the resources as well as the background information on our resources webpage.
For more information, please contact Yasser Ismail, Evaluation Specialist, ext. 598.
To learn more about the Quality Management Partnership, please visit our website.
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Remembering Dr. Roy Beckett
A pioneer of modern peer assessment
 Dr. Roy Beckett is being remembered as an innovative leader in the development of physician peer assessment and as a champion of modern medical regulation.
Dr. Beckett passed away on August 11, 2016. For many years, he was an associate registrar and medical advisor at the College, where he brought keen oversight and innovation to how the College undertook physician registration and assessment, and pioneered some of the earliest work in quality improvement. Throughout the 1980s and 90s, Dr. Beckett was instrumental in the development of the peer assessment program. He championed assessment procedures that addressed the particular circumstances of each physician’s practice. He also worked hard to support and guide early peer assessment committees so that today, we have a program built on a commitment to balance individualized feedback with a standardized approach -- while always maintaining physician dignity. Thanks in no small measure to his dedication, our peer assessment program became a model for national and international medical regulators.
Prior to working for the College, Dr. Beckett was the Chief of Surgery at the Oshawa General Hospital. In 1993, he retired from the College, but continued to work as an independent medical advisor for many years after. Dr. Beckett will be greatly missed by his friends and colleagues at the College, and we are grateful for his vision and work that helped lay the foundation and guiding principles for today’s peer and practice assessments.
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Assessor Notebook
Check Us Out
 Updated Peer and Practice Assessment Process Webpage
We’ve updated our Peer and Practice Assessment Process webpage to provide more useful information about what is reviewed during an assessment and the possible outcomes. Please take the time to look – we hope it will provide clarity on the assessment process for both assessors and assessed physicians.
Online resources for assessors
Our Professional Role Resources webpage has a number of documents, guides and self-assessment tools that may be useful when conducting assessments. You’ll find links to such topics as the College’s continuing education requirements, the Good Practices Guide and the CMA Code of Ethics as well as many other practice improvement and education resources. Take a look!
Reminders
 Have you switched from a PC to a MAC? Get a new USB drive
All assessors received an encrypted USB drive to store their CPSO related work. If you recently changed your computer from a PC to a MAC, you may need an updated USB drive version so that you can properly save your assessment reports. For more information, please contact Claudia Frisch.
Don’t be tardy with those reports!
Please remember to send us your assessment reports by the due date. This is very important to allow us to complete the full assessment process in a timely manner and reduce the anxiety that we know is felt by physicians undergoing assessment.
If you know you won’t be able to submit your report on time due to unavoidable circumstances, be sure to contact your assessment coordinator as soon as possible.
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Evaluation of CPSO Registration Pathways - Update
 As we have previously reported to you, the College is evaluating its registration pathways and policies by comparing the performance of physicians who were registered through traditional and alternative routes.
Since June 2013, 1,790 Pathways assessments have been initiated to collect information on physician performance through our peer assessment program as well as from Multi-Source Feedback (MSF). The MSF gathers information from assessors, physician colleagues, co-workers and patients, and examines a broad range of CanMeds roles such as Medical Expert, Communicator, Collaborator and Professional. We are very pleased to report that 88% of the assessments are complete and we expect to finish the remaining assessments by the end of 2016.
Once we finish all the assessments, the next step will be to triangulate the results with complaints data from the College’s Investigations and Resolutions department and administrative data from the Institute for Clinical Evaluative Sciences. This will provide us with a comprehensive picture of practice and allow for a thorough evaluation of the College’s registration pathways.
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CPSO Policy Consultations – Have Your Say
 The College regularly conducts consultations to obtain feedback on new and revised policies, as well as existing policies that are under review. The feedback we receive helps us to assess policies and determine the issues we should consider throughout the review process. The College also often asks for input from physicians and the public when we are reviewing proposed government legislation.
Consultations currently underway are:
Physicians and Health Emergencies: This policy re-affirms the professions’ commitment to the public in times of health emergencies. The policy was produced after the SARS epidemic and the H1N1 pandemic. The policy is now under review in accordance with our regular review cycle.
College Oversight of Fertility Services – Regulation Change Proposal: The College is proposing an amendment to Ontario regulations that would authorize the College to enter and inspect premises where fertility services are being performed, regardless of whether anaesthesia or sedation is used.
We hope you will take a moment to review each consultation page and share your comments. You can keep up with all current consultations, submit your comments and review all the feedback received by visiting our consultations page.
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Meet CPSO Assessor Dr. David Finkelstein
Otolaryngology Assessor and Network Lead
 Dr. David Finkelstein is an Otolaryngologist (Head and Neck Surgery) at the Southlake Regional Health Centre (SRHC) in Newmarket. His practice focuses on caring for patients with endocrine, salivary and upper aerodigestive tract tumours. He has held several administrative positions at SRHC, including Chief of Surgery, President of the Medical Staff Association, and Chair of the Infection Control Committee, all of which led to his interest in Quality Metrics and Patient Safety. Dr. Finkelstein was recently appointed Physician Lead for Quality and Patient Safety at SRHC. He has been a peer assessor and our Network Lead for Otolaryngology – Head and Neck Surgery since 2011.
What valuable information have you gained/shared as an assessor?
Without a doubt, the most valuable and, in my opinion, laudable information I have gained is the knowledge that a strong majority of my colleagues are practising at a very high level of competence and, notwithstanding that, are anxious to improve upon their performance. The willingness to hear me out as an assessor and discuss alternatives, particularly in the way information is documented, has similarly been very valuable and rewarding.
What do you focus on when doing assessments?
As much as possible, and within the boundaries of the known "checklists" provided for each individual by the CPSO, I try to focus on the "real world" work my colleagues are doing. I don't take the position that the person being assessed has to provide Ivory Tower answers for every clinical problem, but do look to ensure they are following the available clinical guidelines. I am also very interested in the "timeliness" of documentation and dictations. I try to keep an open mind when documentation methodology is different from my own, and indeed have learned several new methods which I have added to my own practice.
What techniques do you employ to lessen the apprehension some may have when being assessed?
I make it very clear that an assessment is not a punitive, "gotcha" episode but rather should be viewed as an educational opportunity to demonstrate the quality of their work and, perhaps, learn a few tricks to improve. I also spend time with them, first on the phone prior to the assessment, and then just before I begin a formal chart review, to allow them to explain the nature of their practice and any information they think important or relevant.
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Kudos for One of Our Own!
Peer Assessor, Dr. Martin White, receives CPSO Council Award
 Dr. Martin White, who has been a peer assessor for the past 10 years, was the recent recipient of a 2016 CPSO Council Award. Congratulations, Marty, from all of us in the Assessor Program. We are very proud of you!
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Meet Your PA&E Decision Writers
 Who we are:
Aleksa Pjanic, Bojana Cvetkovic, Trisha Papas and Kimberly Mistysyn.
What do we do?
As the decision writers, we write the letters that notify physicians of the outcome of their practice assessment after their case is reviewed by one of our practice assessment and enhancement (PA&E) committees. Those committees include the Quality Assurance, Premises Inspection, Methadone, and Independent Health Facilities committees. We attend all committee meetings and write a summary of the committee’s findings.
How do we do what we do?
Before each meeting, we carefully review the meeting materials because that helps us to follow the meeting discussions and document relevant committee comments. During the meeting, we listen very carefully to each case discussion. A committee will typically review 30-40 cases per meeting.
After the meeting, we re-fuel with caffeine, chocolate or candy (we are not picky) and get ready for the task at hand. That means writing dozens of letters that summarize each decision, based upon the committee’s discussions as well as assessor reports and other case materials.
The assessor reports provide us with context for understanding medical procedures and terminology specific to various scopes of practice. We also often liaise with other College staff to make sure our letters are thorough and accurately capture the committee’s decision. Once that’s done, we send our draft letters to the meeting Chair for review and approval.
What we enjoy about our role:
We enjoy working together as a team and with College staff and committee members. The variety of cases can be an interesting challenge, but it keeps us on our toes!
What we really enjoy about our role:
Again, we enjoy chocolate (dark or milk, if you’re wondering!).
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For more information or help with any of the above items contact Claudia Frisch or 416-967-2600 ext 586.
Assessor News is produced by the
College of Physicians and Surgeons of Ontario.
Please visit our website at www.cpso.on.ca
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