Accreditation: A Quality Improvement Strategy for the Community-Based Family Practice.

Five Alberta family practices were the first of their kind to pursue Accreditation Canada's Primary Care Accreditation in 2013-2015. This study examines the impact of accreditation as a quality improvement (QI) strategy for community-based/fee-for-service family practices. Pre-/post-accreditation data received on clinic compliance with accreditation standards, provider-reported work-life and patients' self-rated health status/care show massive improvement in accreditation-rated compliance scores, which were disproportional to provider-/patient-rated changes. A Donabedian-inspired explanation states that accreditation measures predominantly structures, whereas survey-sought provider/patient perspectives focus on process and outcomes. Costs and human resources burdens aside, clinics saw benefits in accreditation-incented QI initiatives and formal recognition of clinic excellence, albeit antecedent.

Achievement of Accreditation by Community-Based Family Practice - Workload and Cost Analysis.

Five Alberta family practices achieved accreditation with Accreditation Canada in 2013-2015. This study conducted a workload and cost analysis of achieving accreditation. Human resources (HR) comprised 95% of the total cost. Document preparation constituted 76% of workload and 68% of total HR costs. Centralized content experts were tasked with document write-up. Clinics focused on survey preparation: 56% of staff participated, with the workload being the heaviest on managers. In CAD (2018 $ value), per capita cost was the highest for the 2-physician clinic ($65.78) and lower for the 11-physician ($19.44) clinic. Other cost determinants included culture, organizational structure, physician/staff engagement and pre-existing compliance to standards. A cost-benefit analysis shall provide insights into system-level benefits.