The importance of action plans in the PPEP assessment process

The Physician Practice Enhancement Program (PPEP) uses a quality improvement approach, collaborating with physicians to provide feedback and coaching, identify areas for improvement, and encourage self-reflection within a culture of learning. To do so, PPEP incorporates the Federation of Medical Regulatory Authorities of Canada’s (FMRAC) physician practice improvement (PPI) model, which uses a Plan-Do-Study-Act approach.  

As part of the assessment process, PPEP puts an emphasis on action plans to provide physicians an opportunity to reflect on the assessment feedback and encourage a more concrete plan for implementing practice changes. The action plan has two components: a reflective piece, and an implementation piece. Drawing from the principles of adult and social learning theories,¹ goal-setting theory, the positive relationship found between clearly identified goals and performance,² ³ and the transtheoretical model of change,⁴ ⁵ the College provides rationale for the action plan, clear instructions and examples for completing it, and tips for putting together an effective plan,⁶ as well as a successful chart submission. 

Action plans are reviewed by program medical advisors, and feedback is provided to give additional coaching on areas that require attention in order to successfully complete the additional remediation steps. 

Action plans are also useful for physicians to plan for their own professional development. The College of Family Physicians of Canada has similarly adopted the use of professional learning plans as a self-directed assessment tool, developed to assist physicians in identifying practice improvement and professional learning goals. Also based on the FMRAC PPI framework, it is a new Mainpro+ certified activity available to Mainpro+ participants. Learn more here.

References:

  1. Bourgeois-Law G, Teunissen PW, Regehr G. Remediation in practicing physicians: current and alternative conceptualizations. Acad Med. 2018 Nov;93(11):1638-44. 
  2. Locke EA. Toward a theory of task motivation and incentives. Organ Behav Hum Perform 1968 May;3(2):157–189. 
  3. Locke EA, Latham GP. Building a practically useful theory of goal setting and task motivation. A 35-year odyssey. Am Psychol. 2002 Sep;57(9):705-17.
  4. Prochaska JO, Redding CA, Evers K. The transtheoretical model and stages of change. In: Glanz K, Rimer BK, Lewis FM, editors. 3rd ed. Health behavior and health education: Theory, research, and practice. San Francisco, CA: Jossey-Bass, Inc; 2002. 
  5. Sutton S. Transtheoretical model of behaviour change. In: Ayers S, Baum A, McManus C, Newman S, Wallston K, J. Weinman, et al., editors. Cambridge handbook of psychology, health and medicine. Cambridge: Cambridge University Press; 2007. p. 228-32.
  6. University of Kansas, Center for Community Health and Development. The Community Toolbox [Internet]. Lawrence, KS: University of Kansas; 2019. Developing strategic and action plans [cited 2019 Sep 26]. Available from: https://ctb.ku.edu/en/developing-strategic-and-action-plans