Predictors of high-performing family medicine clinics: Prospective cohort study in Alberta

To identify potential risk and protective factors associated with family medicine (FM) and general practitioner (GP) group performance.

Prospective cohort study of FM and GP clinics in Alberta, using a Group Practice Review (GPR) framework.

FM and GP clinics operating in Alberta between 2017 and 2019.

Seventy randomly selected FM and GP clinics.

Clinics were observed and assessed as part of the GPR. Group performance was assessed based on compliance with applicable College of Physicians & Surgeons of Alberta (CPSA) standards of practice (SOPs). Data on physicians' demographic characteristics, practice characteristics, chart scores, and prescribing information were collected from CPSA databases and self-reports.

Predictors of high-performing clinics, defined as meeting 90% or more of applicable SOPs, were identified using logistic regression.

Four key predictors of group performance (SOP compliance) were identified: prescribing practices, number of workdays per week, number of physicians, and chart scores. Clinics with higher rates of risky prescribing and heavier workloads were less likely to comply with SOPs, while clinics with more physicians and higher chart scores were more likely to be classified as high performing.

This study is among the first to examine predictors of group performance in FM and GP group practices. Findings highlight the importance of monitoring prescribing behaviour, workload, and chart scores at the clinic level to support physicians and protect patients.