Performance

Medical school participation in any new performance management framework
The Papadakis Article evidences that behavior in medical school is strongly linked with behavior as a physician. While it is difficult to suggest the level at which
information should be shared, in a closed system where BC trained doctors are likely to work and practice in BC, the links cannot be ignored. UBC, as the only
medical school in the Province, should be brought into the discussion to assess whether a system could be developed to provide early warnings for HAs and
other prospective employers.
Suggestion for Improvement #11: The Terms of Reference for each Joint Advisory Committee between the HAs and UBC should be amended to include issues
of performance management and remediation, including:
Discussing performance issues of residents in the HA; and
Discussing remediation opportunities for individual physicians, as well as broader systemic remediation program requirements.
HA systems for granting privileges
Our review uncovered a number of inefficiencies in the process that HAs use to grant privileges. While the process for granting privileges needs to be rigorous,
the current process is cumbersome and causing some within the system to overlook certain steps. Opportunities to improve the process uncovered through this
review include:
Reviewing the role of either the local credentials committee and local medical advisory committee in reviewing and approving applications;
Completing the digitization of the process and have all application forms completed online;
Processes need to take into account standardizing processes for physicians with privileges in multiple HAs 48 ;
Moving from an annual to bi-annual appointment timeframe and stagger the re-appointments. FHA is currently adopting this approach so that it reduces
the number of applications being considered at any given time, thus spreading out the work to allow Regional Department Heads to do their due
diligence on the application; and
One HA CEO also thought that going to staggered multi-year appointments might also provide the opportunity to create greater linkages with peer
review processes.
Suggestion for Improvement #12: While a number of the initiatives launched by the Ministry in response to Dr. Cochrane’s report address some of the
inefficiencies identified above, the Ministry should mandate that HAs implement and effectively use the new systems being developed to minimize the risk of
different levels of uptake in different HAs.
48 We acknowledge that one of the Ministry’s initiatives in the Physician Quality Assurance Portfolio has recently developed a standard form which can be used
across the HAs.
Ministry of Health 55
Provincial Review of Physician Licensing, Credentialing, Privileging & Performance Management
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