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Physician Practice Improvement– By The Numbers

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December Messenger 2020, In the Community | Posted December 14, 2020

Using data and facilitation to drive learning and change


Dr. Kelly Burak’s interest in education began at a young age. Growing up in Saskatchewan, his parents were both teachers who taught him the importance of learning.

“I always wanted to teach, and there is no shortage of opportunities for education and learning in medicine,” shares Dr. Burak.

In addition to his clinical practice in Hepatology, Dr. Burak is the Associate Dean of Continuing Medical Education (CME) and Professional Development (PD) at the University of Calgary, as well as a Professor of Medicine in the Departments of Medicine and Oncology. Alongside his master’s degree in Epidemiology, Dr. Burak also has a graduate certificate in Clinical Education. Four years ago, he joined Alberta’s Physician Learning Program (PLP) as co-lead.

“I joined the PLP at a time in my career when I was looking for opportunities to be more impactful,” says Dr. Burak. “The position appealed to my life-long interest in education and I was attracted to what the merger of quality improvement, knowledge translation and continuing professional development (CPD) could mean for physicians.”

Dr. Burak believes in the use of data, audit and feedback to drive knowledge, learning and ultimately, change.

“Traditional CME, like conferences, are informative and clinical practice guidelines can be helpful, but we know they’re not always followed,” he says. “It’s difficult to measure the impact that type of education actually has on physicians and patient care. There’s a gap between knowledge and action.”

One of the first projects Dr. Burak helped lead at the PLP was audit and feedback of endoscopy use for young patients with dyspepsia. The goal was to reduce low-value procedures that didn’t contribute to a patient’s care and only added costs to the healthcare system. Partnering with Calgary gastroenterologists, they performed an audit of endoscopes in accordance with recommendations from Choosing Wisely. The PLP facilitated the feedback of the clinical information to physicians and helped develop tools to support physicians and patients. When remeasured, the number of low-value endoscopies in the Calgary zone had decreased by about 300 per year.

“Facilitation is key to understanding the data, recognizing its limitations and helping physicians move toward changing their practice,” says Dr. Burak. “This project really helped me understand the importance of data-driven quality improvement and how it can change behaviour. We don’t always know how to make changes on our own and it’s hard to change without actionable information. Gathering data, understanding what it means and using methodology aimed at continuous quality improvement is the first step towards being able to make meaningful change and measure its impact.

“It’s a different way of approaching our CPD,” continues Dr. Burak. “But ultimately, it should help us perform better as physicians, which leads to healthier patients, a happier physician workforce and overall sustainability of the healthcare system.”

Given his passion for learning, it’s no surprise Dr. Burak strongly believes physicians need to be open to continuous feedback and improvement throughout their careers.

“Medicine changes rapidly—COVID has really taught us that. Traditional CME is not going away, but merging the process with quality improvement, making action plans based on data and being able to measure our success by shifting the curve is exciting.”

Physicians in Alberta who need resources to start their practice improvement journey can reach out to the University of Calgary’s Office of CME and PD for more information.

“Ultimately, we don’t want practice improvement to be an additional burden on physicians,” says Dr. Burak. “We want to work with our partners and develop a system to streamline the process. When we all work together, it makes everyone better.”

For more information about the Physician Learning Program, please visit their website

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