Effective tools and standardized methods for monitoring physician performance have been slow to emerge. However, in 2006, Toronto East General Hospital developed the Physician Activity Report (PAR) to fill this void. The PAR is a standardized, cross-specialty physician performance report designed to improve patient care, and support a data-driven evaluation and credentialing process. The PAR was co-developed by physician and administrative leadership at the hospital. To ensure construct validity and physician support for the report, the CanMEDS framework for physician competencies was leveraged. The PAR identifies 7 key physician roles: medical expert, communicator, collaborator, manager, health advocate, scholar, and professional. Each role has standardized competencies and twelve performance measures. Through these measures, the PAR is able to quantifiably evaluate physician performance in each of their required roles. The PAR effectively improved the transparency, clarity, and objectivity of the physician re-appointment process by embedding an empirical element into the decision-making process. The first physician satisfaction survey conducted after the introduction of the PAR illustrated the positive outcomes of this innovation: 89% of physicians rated their understanding of the annual reappointment process as being good, very good or excellent; positive scores for physician engagement increased by 11% from pre-PAR surveys; and 90.7% of physicians felt they had a clear understanding of their goals and objectives.
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