A Synthesis of Quality Improvement and Accreditation Mechanisms in Primary Healthcare

Full Report (PDF, 1.07 MB) 

Maeve O’Beirne, PhD, MD, FCFP
Associate Professor, Departments of Family Medicine and Community Health Sciences, University of Calgary

Nelly D. Oelke, PhD, MN, RN
Assistant Professor, School of Nursing, University of British Columbia, Okanagan Campus

Pam Sterling, BSc, PMP
Associate Director Research, Department of Family Medicine, University of Calgary

Jana Lait, MA
Research & Evaluation Consultant, Workforce Research & Evaluation, Alberta Health Services, Calgary

Karen Zwicker, BScH
Ward of the 21st Century Research Centre, Faculty of Medicine, University of Calgary

Richard Lewanczuk
Senior Medical Director, Primary & Community Care, Alberta Health Services, Edmonton

William Ghali
Director, Institute of Public Health, Faculty of Medicine, University of Calgary

Helen Lee Robertson
Associate Librarian, Health Sciences Library, Faculty of Medicine, University of Calgary

Maryna Korchagina
Senior Manager, Health Care Provider Compensation, Innovative Compensation Branch, Health Workforce Division, Alberta Health and Wellness

Key Messages

  • Quality improvement (QI) strategies are appropriate for improving certain clinical outcomes such as increasing colorectal screening and increasing foot examination rates for diabetic patients.
  • It is difficult to evaluate the outcomes of QI strategies in primary healthcare because the approaches used vary and are often multifaceted.
  • Studies measuring patient or provider perceptions of QI are few given the design constraints of randomized controlled trials, time-series studies and before-after studies.
  • Currently, primary healthcare accreditation is non-government funded and voluntary with some countries offering financial incentives.
  • There is a lack of research on primary healthcare teams and QI and accreditation; what little research is available is mostly done with family physicians.
  • Further research is required in QI in primary healthcare including: the effect of QI on a broader range of patient outcomes; the most effective method for improving patient outcomes; impact on healthcare utilization; cost effectiveness; and impact on patient and provider perceptions.
  • Research is required in primary healthcare on the effects of accreditation including: the effect of accreditation on patient outcomes; whether accreditation is an effective method to improve quality of care; impact on healthcare utilization; cost effectiveness; and impact on patient and provider perceptions.