Evaluation and improvement of medical practices in Quebec

In Quebec, the evaluation of health care providers' practices is organized for each professional group. It is an official pari of the health care regu lation policy and is defined by legal texts. Evaluation of medical practice s is controlled by physicians through their professional order and consulta tive medical councils in hospitals. The role of the College des Medecins du Quebec is to warrant the quality of medical acts. The College watches over the quality of the physician's init ial education using a process of agreement for ail training departments and for the medical school curriculum. Young graduates must pass the College's examination before being licensed to practice The College watches over imp rovements in professional practices via inspections of individual practices and hospitals and continuous education programs. There are three levels of physician supervision: screening for poor practices, inspection, and in-de pth investigation. In hospitals, a consultative medical council is in charg e of assuring quality medial practice. Mortality and morbidity conferences, claims analysis, audits with explicit evaluation criteria and indicator mo nitoring are the basic tools used for assessing the quality of medical prac tice. The Quebec experience demonstrating how a medical profession can organize a full system for evaluating medical practice can be a model for other count ries.