The problem

Long-term care (LTC) homes play an important role in our health care system by supporting care of residents who are increasingly frail and live with many co-morbidities. In LTC homes, quality measures collected through the resident assessment data (through the interRAI MDS quality indicators) are commonly used to evaluate the care outcomes of residents and the LTC home as a whole. However, these quality measures lack the ability to measure the performance of Primary Care Providers (PCPs) who provide care for residents.

This leads to three negative consequences:

  • The ability to track PCP adherence to best practice guidelines and consistency of care is hindered;

  • A LTC home cannot compare performance between PCPs which results in ineffective quality improvement;

  • Without quality measures that show the value of PCPs in LTC, insight into optimal organizational models is lost.

The question

PCP involvement is an important factor in resident quality of care. This study will aim to develop a Primary Care Provider Quality Score(PQS). This will be done by refining and operationalizing process-based quality measures in the real-world LTC setting to calculate the PQS.

Our approach

With a Technical Expert Panel, we are selecting quality measures for PCP process-based performance. Then, the quality measures will be operationalized by a working group comprised of Medical Directors of LTC homes and researchers.

We will collect data through a retrospective chart review at participating LTC sites to test the selected quality measures. Once refined and tested, the PQS will be translated into a toolkit that LTC homes and quality assurance agencies can use to reliably measure quality of care for residents. 

Our Team

This is a collaboration across multiple North American LTC providers and researchers.

Team Leads:

Andrew P. Costa, PhD | McMaster University

Andrea Moser, MD, MSc, FCFP, CMD | Baycrest Health Sciences Centre, The Jewish Home for the Aged/Apotex Centre

Team Members:

Darly Dash, MSc | McMaster University

Amina Jabbar, MD, MSc | McMaster University

Derek Manis, MHSc | McMaster University

Komal Aryal, BSc | McMaster University

Jeff Poss, PhD | University of Waterloo

Sally Moy | Baycrest Health Sciences Centre

Jordan Lass | Baycrest Health Sciences Centre

Tina Booker | University of California – Los Angeles


Paul Katz, MD, CMD | Florida State University College of Medicine Health, Borun Center for Gerontological Research

Sid Feldman, MD, CCFP, FCFP, CMD | Baycrest Health Sciences Centre, The Jewish Home for the Aged/Apotex Centre

George Heckman, MD | University of Waterloo, Schlegel-UW Research Institute for Aging

Debra Saliba, MD, MPH | University of California – Los Angeles, RAND 

Martin Smalbrugge, MD, PhD | Amsterdam Public Health Research Institute

Jurgis Karuza, PhD | SUNY Buffalo State

Cees Hertogh, MD, PhD | Amsterdam Public Health Research Institute

John Hirdes, PhD | University of Waterloo


Thanks to the following sites for their participation and contributions.

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Researcher-Clinical Partnership Program