title: Evaluation of the physician quality improvement initiative: the expected and unexpected opportunities.
abstract: BACKGROUND
  The Physician Quality Improvement Initiative (PQII) uses a well-established multi-source feedback program, and incorporates an additional facilitated feedback review with their department chief. The purpose of this mixed methods study was to examine the value of the PQII by eliciting feedback from various stakeholders.
  
  
  METHODS
  All participants and department chiefs (n = 45) were invited to provide feedback on the project implementation and outcomes via survey and/or an interview. The survey consisted of 12 questions focused on the value of the PQII, it's influence on practice and the promotion of quality improvement and accountability.
  
  
  RESULTS
  A total of 5 chiefs and 12 physician participants completed semi structured interviews. Participants found the PQII process, report and review session helpful, self-affirming or an opportunity for self-reflection, and an opportunity to engage their leaders about their practice. Chiefs indicated the sessions strengthened their understanding, ability to communicate and engage physicians about their practice, best practices, quality improvement and accountability. Thirty participants (66.7 %) completed the survey; of the responders 75.9, 89.7, 86.7 % found patient, co-worker, and physician colleague feedback valuable, respectively. A total of 67.9 % valued their facilitated review with their chief and 55.2 % indicated they were contemplating change due to their feedback. Participants believed the PQII promoted quality improvement (27/30, 90.0 %), and accountability (28/30, 93.3 %).
  
  
  CONCLUSIONS
  The PQII provides an opportunity for physician development, affirmation and reflection, but also a structure to further departmental quality improvement, best practices, and finally, an opportunity to enhance communication, accountability and relationships between the organization, department chiefs and their staff.
authors.affiliation: Department of Family and Community Medicine, Division of Palliative Care, University of Toronto, Toronto, ON, Canada. Kirsten.Wentlandt@uhn.ca.|Medical Affairs, University Health Network, Toronto, ON, Canada. Kirsten.Wentlandt@uhn.ca.|Toronto General Hospital, UHN, 9NU-925, 200 Elizabeth St, Toronto, ON, M5G 2C4, Canada. Kirsten.Wentlandt@uhn.ca.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Wentlandt
authors.affiliation: School of Public Policy and Governance, University of Toronto, Toronto, ON, Canada. andream.bracaglia@gmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bracaglia
authors.affiliation: School of Public Policy and Governance, University of Toronto, Toronto, ON, Canada. jamesdrummond50@gmail.com.
authors.forename: James
authors.initials: J
authors.lastname: Drummond
authors.affiliation: School of Public Policy and Governance, University of Toronto, Toronto, ON, Canada. ldhandren@gmail.com.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Handren
authors.affiliation: School of Public Policy and Governance, University of Toronto, Toronto, ON, Canada. joshuajeremiahmccann@gmail.com.
authors.forename: Joshua
authors.initials: J
authors.lastname: McCann
authors.affiliation: Human Resources, University Health Network, Toronto, ON, Canada. Catherine.Clarke@uhn.ca.
authors.forename: Catherine
authors.initials: C
authors.lastname: Clarke
authors.affiliation: Corporate Planning, University Health Network, Toronto, ON, Canada. Niki.Degendorfer@uhn.ca.
authors.forename: Niki
authors.initials: N
authors.lastname: Degendorfer
authors.affiliation: Medical Affairs, University Health Network, Toronto, ON, Canada. Charlie.Chan@uhn.ca.|Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada. Charlie.Chan@uhn.ca.
authors.forename: Charles K
authors.initials: CK
authors.lastname: Chan
mesh_terms: D000288:Administrative Personnel; D001291:Attitude of Health Personnel; D005260:Female; D000068156:Formative Feedback; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D017060:Patient Satisfaction; D010380:Peer Review; D010820:Physicians / Q000592:standards*; D015397:Program Evaluation / Q000379:methods; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D058996:Quality Improvement / Q000458:organization & administration / Q000592:standards; D012647:Self-Assessment; D012941:Social Responsibility; D011795:Surveys and Questionnaires