Quality Indicators, Summer 2021

The Role of Provider Experience in Quality Healthcare

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Like the focus on patient experience, measuring the experience of healthcare providers can help uncover important health system improvement opportunities.

There is a well-established link between healthcare provider experience and patient outcomes. For example, many studies of burnout among clinicians and staff in healthcare have shown the negative impacts on patient care and outcomes. Research demonstrates that physician burnout is associated with an increased risk of patient safety incidents and poorer quality of care due to low professionalism[1], dissatisfied physicians are more likely to prescribe inappropriate medications, which can result in expensive complications[2], patient safety is threatened by nurse dissatisfaction, and many nurses report that their workload causes them to miss important changes in their patients’ condition[3].

Yet measuring the experience of community pharmacy professionals within the context of healthcare quality and outcomes has never been done before–a literature review conducted by the College found no community pharmacy-specific measures identified here in Canada or around the world.

As part of the College’s Quality Indicators initiative, a working group of frontline pharmacy professionals, patients, and health and data experts has been formed to identify meaningful indicators that will measure provider experience. Quality indicators already exist in other areas of the health system, such as long-term care and primary care, and a great deal of work has already been done to establish indicators in hospital pharmacy. However, it is relatively new territory for community pharmacy in Ontario, which is why it is the focus of this current indicators work. The working group has been reviewing existing indicators from other disciplines, and will recommend a shortlist of these indicators for public consultation this summer

A list of confirmed provider experience measures will be finalized based on stakeholder feedback and presented to the Board in December 2021. The College will also use the public consultation to explore options for collecting the data going forward.

Community Practice Environment

The work to develop provider experience indicators complements the Community Practice Environment Initiative, aimed at understanding and addressing the barriers to patient safety in community pharmacy. This initiative resulted in a set of shared accountability principles, approved by the College’s Board of Directors in December 2020. These principles provide all pharmacy stakeholders with a foundation to guide decision making that supports consistent delivery of safe, high quality patient care at all times within a community pharmacy environment.

An implementation strategy is currently being developed that will involve each stakeholder playing an important part in the rollout, promotion and adoption of the principles throughout the profession.

While the selection of provider experience measures is a separate stream of activity, the environment that pharmacy professionals practice within does affect the experience of providing care. Therefore, the development of principles of shared accountability will inform the selection of provider experience measures and contribute to the College’s efforts to support safe and effective patient care.

Information about the Community Practice Environment and the Quality Indicators initiatives will continue to be shared in future editions of e-Connect and Pharmacy Connection.

  1. Panagioti, M., Geraghty, K., Johnson, J., Zhou, A., Panagopoulou, E., Chew-Graham, C., … & Esmail, A. (2018). Association between physician burnout and patient safety, professionalism, and patient satisfaction: a systematic review and meta-analysis. JAMA Internal Medicine, 178(10), 1317-1331.
  2. Williams, E. S., & Skinner, A. C. (2003). Outcomes of physician job satisfaction: a narrative review, implications, and directions for future research. Health Care Management Review, 28(2), 119-139.
  3. McHugh, M. D., Kutney-Lee, A., Cimiotti, J. P., Sloane, D. M., & Aiken, L. H. (2011). Nurses’ widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health Affairs, 30(2), 202-210.

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