promoting regulatory excellence self assessment & physiotherapy: the ontario model jan robinson,...
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Promoting Regulatory Excellence
Self Assessment & Physiotherapy: the Ontario Model
Jan Robinson, Registrar & CEO,
College of Physiotherapists of Ontario
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
2
Presentation Outline regulatory context program history current program learnings where to next
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Regulatory ContextSelf regulatory modelQuality assurance is mandated ≈7,000 registered physiotherapists 40/60 split public/private care models
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Quality Management
Assure quality practice
Promote continuing
competence
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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➔ not a science ➔ start somewhere
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Time when continuing professional development (CPD) hours were primary example
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Initial programLearning logCollege Review Program (5 components)Practice Review
Rheumatoid Arthritis Lower Extremity Function Disabilities of Arm, Shoulder & Hand
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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2001 Program Challenges not used fairness? subjectivity onerous research findings vs. influence on
competence
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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2002 – 2004 extensive evaluation and program development
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Current Quality Management Program evidence based confidential evolves under continu0us evaluation shared accountability
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Practice Reflection
Goal : To promote registrant self-assessment, professional accountability and practice reflection to continuously improve the quality of professional performance.
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Two mandatory elements portfolio PISA (Professional Issues Self-
Assessment)
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Portfolio provides evidence of ongoing learning over fourteen (14) web based tools to
customize
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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PISA (Professional Issues Self-Assessment) 20 questions change annually interactive, online
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Practice Assessment
Goal: To allow registrants to demonstrate competency while providing a positive learning experience.
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Practice Assessment Tool
Domains assessed: Practice Issues Billing Professional Portfolio
Review Record Keeping Chart Stimulated
Review
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Key success factors tools reliable & valid assessor calibration procedural fairness
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Committee Review blinded physiotherapist input all other relevant College data provided
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Outcomes
1. Satisfactory no further action2. Self directed Practice Enhancement3. Committee Directed Practice
Enhancement (two options)
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Resources for support focus groups video webcasts teleconferences online tutorials interactive tools electronic links to resources
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Practice Enhancement
• Goal: To assist registrants to meet competence standards
PTs in clinical practice identified as having gaps in knowledge, judgment, skills and/or abilities.
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Post Visit Questionnaire Data
78% response rate 2008/2009 66% response rate 2007/2008 71% response rate 2006/2007
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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How confident are you that on the whole the Practice Assessment
reflects your practice?
0
10
20
30
40
50
60
%
1 (Low) 2 3 4 5 (High)
2008/09 2007/08 2006/07
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Annual Conference
September 10-12
Denver, Colorado
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020406080
100
%
Practice Billing Portfolio Recordkeeping
CSR
2008/09 2007/08 2006/07
How relevant were the components of the assessment to your practice? Ratings provided as a percentage of those who responded either
4 (relevant) or 5 (very relevant).
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Did your participation in this process assist you in identifying any
learning needs?
0
20
40
60
80
%
2008/09 2007/08 2006/07
Yes No
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Self identified areas for ongoing learning
0
20
40
60
80
%
2008/09 2008/07 2006/07
Record Keeping Practice Issues CSR Portfolio
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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How well did the Assessment meet the intended goal?
0
20
40
60
%
1(Low) 2 3 4 5(High)
2008/09 2007/08 2006/07
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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“I don't need this process to demonstrate my competency or ongoing learning. But I imagine some PTs do, and the process has to be standardized for all. However, I doubt other registered health practitioners … jump through all these hoops!!!!”
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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“Definitely a positive learning experience. For those of us who actually care that we are doing a good job, it provides a time to reflect and critically evaluate all that we do.”
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Continuous Improvement of the Program
currently under review against evidence in area of reflection, more specifically related to
➔ practice drift ➔ self assessment ➔ Feedback
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Under Consideration language shift – continuous
improvement; shared learning guided reflection structured in all 3
program components multisource data input – voluntary &
mandatory registrant skill building on effective use
of feedback building communities of practice
CLEAR 2009
Annual Conference
September 10-12
Denver, Colorado
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Questions….
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