Practice Support Program implementation the focus of mid-term review

Issue: BCMJ, Vol. 50, No. 9, November 2008, page(s) 497 GPSC
Liza Kallstrom

A mid-term review recently con­ducted for the Practice Support Program (PSP) provides excellent guidance for further PSP development and improvement, ac­cord­ing to the program’s BCMA and Ministry of Health Services co-leads.

Consultants interviewed the program’s family practice physicians and medical office assistant “champions” and held focus groups with regional coordinators. Their intent was to evaluate implementation of the program, launched in 2007 to help FPs redesign their practices to improve both quality of patient care and administrative efficiency. FPs and their MOAs learn about, test, and implement changes in their practices with support from their local health authority PSP team, including FP and MOA program champions.

A highlight of the review is the finding that the PSP is widely seen as successful and helpful. It’s also seen as fostering a new spirit of collaboration among health system stakeholders.

“This is a significant achievement,” says Ministry of Health Services PSP co-lead Rosemary Gray. “We see strong linkages developing between health authority staff and independent family physicians, which will benefit patients in the long run.”

Outstanding concerns to be addressed
While the program is a success, some concerns around its implementation were identified in the review. Many of those issues have been resolved as a matter of course as implementation proceeds, and the program’s leads are taking steps to address others where possible.

For example, some participants felt that FP champions with previous quality improvement experience were able to participate more in the delivery of PSP modules than those who were new to such practices. The PSP co-leads will address this concern by offering quality improvement training and support through Impact BC, which has established a new “quality learning network” to support the PSP and related BC improvement initiatives. Dedicated subject matter ex­perts and improvement coaches will be hired to support PSP integrated regional teams.

There was also concern among participants about the PSP policy limiting FPs to taking only two of the available modules. The program leads have adjusted the second phase of PSP so that the chronic disease management module will incorporate both group medical visits and patient self-management, giving participants “three topics in one.” In addition, at least one health authority (Interior Health) will offer evening sessions on practice efficiency outside of the formal PSP structure.

FP and MOA champions have played a key role in the PSP to date, but there is some concern about the demands on these individuals. Supporting existing champions and recruiting new ones will be a focus of the PSP’s second phase. A provincial pool of FP and MOA champions willing to provide support outside their local areas is also being developed.

PSP: On the right track and full-steam ahead
Both PSP leads are receptive to the ideas suggested by review participants and many are now under serious consideration. They agree, for instance, that in addition to this provincial evaluation, reviews of other aspects of the program could lead to evidence-based changes in the PSP.

“On the whole, we’ve already come a long way toward addressing the suggestions in the review,” says Ms Gray. “These interviews and focus groups were held in the spring, and we’ve incorporated their feedback to improve the program in plans for the coming year.”

It’s gratifying to hear the positive things that people are saying. Many participants feel the PSP has reinvigorated interest in family practice, which was one of the main goals.

For the final review, as well as the PSP leads’ full management res­ponse, visit

—Liza Kallstrom
Lead Change Management and Practice Support, BCMA