Welcome to the 2016 CPSA Annual Report

We are thrilled to share our year with you.

 

Good Medical Practice - It's what we're all about

The College of Physicians & Surgeons of Alberta (CPSA) regulates the practice of medicine in Alberta. The privilege of self-regulation is granted through Alberta's Health Professions Act.

Download a copy of the full report or scroll down to see highlights of our year.

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"The 2016 Annual Report... is a story of transition."

-Dr. James Stone, Council President

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Our profession cares - a lot. 

That's what I know after several years on Council, and two as Council President. In a world where cynicism seems rampant, I am heartened by the deep commitment of my colleagues and this College to serving the needs to Albertans through the delivery of safe and competent care. 

The College's 2016 Annual Report, approved by Council, is the story of a year of transition. 

We tackled big issues, including the overuse of opioids in our province and the need for a legal framework for eligible patients to receive medical assistance in dying. We set new strategic goals, and successfully conducted a North America-wide search for a new Registrar to assume the operational leadership of the College in 2017, a role Dr. Trevor Theman has filled admirably. 

The years ahead promise to be just as challenging. While I've completed my term as Council president, I look forward to staying involved and staying in touch, contributing as a physician and citizen to the work of this College, in the service of Albertans. 

 
 

From our Public Council Members

As public members, we represent Albertans, from the newest baby to the eldest senior, every person who needs a doctor's care in our province. 

That's a big job, and we take it very seriously. 

We bring expertise in business, law, governance, education and human resources to our work on Council and Council committees. 

Our perspective helps shape Council decisions on issues that matter to Albertans...
— CPSA Public Council Members

Our perspective helps shape decisions on issues that matter to Albertans, such as new rules for specialist referrals that will improve the patient experience, and guidance for physicians on medical assistance in dying. 

We have a mutually respectful relationship with our physician colleagues on Council, and appreciate the privilege of doing this important work on behalf of Albertans. 

Ms. Cathy MacDonald

Ms. Cathy MacDonald

Ms. Janet Blayone

Ms. Janet Blayone

Ms. Margaret Munsch

Ms. Margaret Munsch

Ms. Kate Wood

Ms. Kate Wood

 
I’m very proud of our accomplishments and our continued commitment to ensuring Albertans receive safe and compassionate care from competent physicians.
— Dr. Trevor Theman, Registrar
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When I joined the CPSA in January 1998 as an Assistant Registrar working in the Complaints department, I had no vision of becoming Registrar. Rather, I joined the College because of the opportunity to work with a high-functioning team that had a clear focus and commitment to ensuring good medical care for Albertans, and internal values and an ethic that matched my own. 

I have never been disappointed in that decision. 

While many of the people have changed, the commitment, values and work ethic that drew me here are as strong as ever. 

We have accomplished a lot - revised and refreshed our strategic plan, moved from paper to digital records, created an online registration system, implemented practice readiness assessments, developed and begun using analytics in physician prescribing practices, refined our complaint processes, applied research methodologies in our competence arena, incorporated risk assessment in our work, engaged the profession with new communication tools, supported provincial and national partners on a variety of initiatives and contributed in many policy arenas, including medical assistance in dying, the use of marihuana for medical purposes, e-health and the opioid crisis. 

I am very proud of our accomplishments and our continued commitment to ensuring Albertans receive safe and compassionate care from competent physicians. 

As I prepare to leave this role, I am confident the dedicated and professional team I've been privileged to lead will be as great a support to my successor in ensuring the College continues to be a leader in medical regulation. 

 
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We register physicians

We review physician education, postgraduate training and, when necessary, arrange assessments to determine whether applicants are ready to practise. Physician practice details are reviewed annually. We also monitor mandatory physician enrolment in Continuous Professional Development.

 

     
     

     

     

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    Top Numbers:

    • 644 new physician registrations (-7.7%)

    • 10,736 total physicians registered (+3.9%)

    • 4,888 Family Medicine specialists, family physicians and general practitioners at Dec. 31 (+3.4%)

    Annual renewal is now part of the student experience

    For the first time in 2016, medical students were included in the annual renewal process for registration with the College - a routine part of being a doctor in Alberta. 

    Updating practice information yearly is important as it helps us assist the public with information about medical services in their communities, monitor practice changes and ensure physicians meet ongoing requirements for professional development and quality improvement. 

    We support continuing competence

    Operating outside the disciplinary process of the College, we regularly assess our members against expected competencies and standards, and educate and support them to implement any necessary practice improvements.

     

     

     

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    Top Numbers:

    • 109 Infection Prevention & Control (IPAC) assessments

    • 402 Physician Achievement Review (PAR) reports completed

    • 111 Individual Practice Reviews

    • 8 Group Practice Reviews

    • 113 Physician Health Monitoring files opened 


    Out with the PAR, in with the new

    Introducing a new collaborative approach to physician competence assessment

    In mid-2016, College Council voted to end the Physicians Achievement Review (PAR) program and replace it with a new, collaborative approach to physician competence assessment and quality improvement. Physicians and patients will benefit from constructive, concrete feedback for both individual and group practice.

    The new approach features three new streams of competence assessment and support, responding to what the College heard from more than 2,000 physicians in focus groups, surveys and face-to-face conversations:

    Practice Checkup. All physicians are included in Practice Checkup, the new analytics-based general assessment process. Drawing on information from College databases, Practice Checkup will provide every Alberta physician with a practice-specific report annually. The report will help physicians gain insight into their practice and highlight opportunities for practice quality improvement and Continuing Professional Development.

    Individual Practice Review (IPR) emphasizes targeted support and education to best help individual physicians grow good practice. Whether a physician is selected or referred from another College program, a trained assessor led by an experienced clinical team will choose from flexible options to meet individual physician needs, working with the physician to identify opportunities to improve and offering support and resources.

    Group Practice Review (GPR) recognizes workflows and processes in multi-practitioner clinics are necessarily different from solo practice. A collaborative process, the GPR involves a clinic visit and follow-up meeting with a trained CPSA Physician Facilitator. Participants will benefit from assistance in identifying practice improvement opportunities and resources tailored to GPR results.

    Introduced in eight clinics in 2016, the GPR will be expanded to another 50 in 2017. The Practice Checkup and IPR will also be introduced next year. The processes, tools and resources will continue to be refined based on participant feedback and research.


    College responds to opioid crisis

    While opioid prescribing has stopped increasing and is starting to come down in Alberta, there is still much to be done. The College is taking action on multiple fronts to guide physicians and their patients onto a safer path:

    • Working with partners
    • Informing Albertans
    • Empowering our members
    • Monitoring and Quality Improvement

    Read more about how the CPSA responded to the opioid crisis in 2016


    Healthy physicians, healthy practice

    For 25 years, the Physician Health Monitoring Program has ensured physicians with health conditions are providing safe patient care. In 2016, Dr. Jeremy Beach joined the PHMP team as the program’s new Assistant Registrar.

    Many physicians with health conditions self-report to the College (82 per cent in 2016). Others are referred by family members or colleagues, or enter the program through our continuing competence or complaints processes.

    Physician health issues are managed confidentially and outside the College’s disciplinary process, with the goals of ensuring physicians are able to maintain their own health and provide safe care. The PHMP liaises with the Alberta Medical Association’s Physician and Family Support Program and other professionals to ensure our members have needed support and remain fit to practise.

    We investigate & resolve physician-related complaints

    We favour an educational or training approach, but apply discipline if necessary.

     

     

     

     

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    Top Numbers:

    • 831 new complaints received (+11.4%)
    • 736 complaint files closed (+7.8%)
    • 702 physicians received a complaint (+12.7%)

    Disposition on intake:

    • 133 directed to informal resolution

    • 437 directed to investigation

    • 261 dismissed


    ...a focus on patient safety, fairness and opportunities to improve medical practice...

    With a focus on patient safety, fairness and opportunities to improve medical practice, the Complaints Director reviews every complaint and determines how to proceed. Options include an informal resolution process, formal investigation or dismissal where there is no or insufficient evidence of professional misconduct. Only a small number of complaints that cannot be resolved informally or involve serious allegations of misconduct are referred to a disciplinary hearing. 

    We measure satisfaction

    After complaint files are closed, all complainants and physician respondents are surveyed on their satisfaction with the complaint process. 

    Informal resolution processes (used for straightforward complaints) receive the highest satisfaction ratings: 

    Direct resolution - resolved directly between physician and complainant. 

    Resolved with consent - College works directly with the physician to resolve the issue with the consent of both parties. 

     

     

    We contribute to public policy

    The College welcomes the opportunity to share its views with government and other healthcare partners, and participate in building a strong healthcare system for Albertans. 

     

     

     

     

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    The College actively contributes to public policy discussions, representing positions that promote quality patient care within a strong public healthcare system. We participate in committees, working groups and meetings with government, business and community leaders. In 2016, College staff and Council members visited Hinton, Edson, Medicine Hat, Lethbridge and Red Deer, meeting with local physicians, community leaders and the public, responding to questions and learning about their healthcare concerns.


    Roadmap to an Integrated Electronic Patient Record

    Every patient in Alberta should have an integrated electronic patient record that is accessible by all healthcare providers involved in the patient’s circle of care, and by the patient as well.

    That’s the College’s vision for eHealth, and now we have a roadmap to get there.

    Imagine a fully integrated system where healthcare providers won’t have to wait for reports to be sent by other healthcare providers or rely on a patient’s memory to make vital care decisions – the information will be at their fingertips, accessible online through a secure portal. And patients will have online access to their own information as well, with greater opportunity to be informed and active participants in their own care.

    In the age of the Internet, patients often assume this is already possible. But expectations have leap-frogged reality, where the complexities of system integration, workflow transition and privacy issues are still being worked out.

    The roadmap – proposed by the College’s Medical Informatics Committee and endorsed by Council in September 2016 – establishes milestones and targets to move these issues forward, acknowledging where the College can take direct action and where our role will be to influence and support broader system development.

    Of most urgent interest to our members are the ‘2020’ targets. By that year we expect to mandate the use of Electronic Medical Records for physician offices, physician contributions to Alberta’s Electronic Health Record (Netcare) and use of the Pharmaceutical Information Network (PIN) to review patients’ medication histories.

    Through a clear and focused vision, engagement with our members and work with our partners, the promise of the IEPR will be realized for Albertans.

    Read the Roadmap


    St. Albert and Sturgeon PCN gets it right

    When the College’s Regional Tour visited St. Albert to listen and learn about local issues, we came away intrigued by the high praise from public attendees for the primary care services in their community, and the value physicians at the table placed on working within a network of health professionals. 

    This was a story we wanted to share. “The St. Albert and Sturgeon primary care network exemplifies what’s best about PCNs,” says CPSA Registrar Dr. Trevor Theman. “They focus on meeting the specific needs of the populations they serve, and their use of other health professionals ensures patients get the right kind of care at the right time from the right provider.” 

    In this special 3-part series, we find out why this PCN is so successful and what’s needed for a strong future.

     

    We accredit health facilities

    We inspect facilities using stringent clinical and safety standards, and approve the physicians who work in these facilities. 

     

       

       

       

       

       

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      Top Numbers:

      • 163 facilities re-accredited
      • 48 new facilities accredited
      • 183 physicians approved to provide specific services in accredited facilities

      New standards coming for DI and sleep medicine

      After many months of work, diagnostic imaging (DI) and sleep medicine providers will soon have new accreditation standards to meet. 

      Evidence-informed and process-based, the new DI standards have already benefited from extensive consultation and will be presented to Council for approval in early 2017. 

      The new sleep medicine standards will extend regulatory oversight to home-based sleep studies that involve our members, and include facility accreditation. These standards are expected to be in place by 2018. 

      We guide professional conduct and ethical behaviour

      The CPSA Code of Ethics, Standards of Practice and Code of Conduct outline the College's expectations of Alberta physicians.

       

         

         

         

         

         

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        Top Numbers:

        • 5 new or amended standards of practice
        • 4 new or revised advice to the profession documents
        • 4 rescinded standards of practice

        Medical Assistance in Dying: A framework for compassionate care

        In June 2016, the College introduced a new standard of practice and advice document for our members on medical assistance in dying, as it became a legal option for eligible patients in Canada.

        In preparing for this day, the College worked for many months with Alberta Health Services, government, other health services providers, patient advocates, legal experts and others to create a clinical, ethical and legal framework for MAID that would meet the needs of Albertans for compassionate and timely care, and help physicians respond to patient requests. 

        As a result of this collaboration, Albertans are well-served by theMedical Assistance in Dying Care Coordination Service established and operated by Alberta Health Services, which aligns fully with the professional standards and advice developed by this College. 

        Learn more: Medical Assistance in Dying standard of practice