• Cheryl A Levitt, Kalpana Nair, Lisa Dolovich, David Price, and Linda Hilts.
• Department of Family Medicine, McMaster University, Hamilton, Canada. clevitt@mcmaster.ca.
• Fam Pract. 2014 Oct 1;31(5):607-21.

PurposePrimary care is the cornerstone of the health care system and increasingly countries are developing indicators for assessing quality in primary care practices. The 'Quality Tool', developed in Ontario, Canada, provides a framework for assessing practices and consists of indicators and criteria. The purpose of this study was to validate the indicators and simplify the Quality Tool.MethodsThis study involved a systematic comparison of indicators in the Quality Tool with those in other local and international tools to determine common indicators to include as valid in the Quality Tool. A Delphi process was used to help reach consensus for inclusion of any indicators that were not included in the comparison exercise.SettingPrimary care in Ontario, Canada.SubjectsKey informants were those with known expertise and experience in quality assessment in primary care.Main OutcomeValidated set of indicators for inclusion in an updated Quality Tool.ResultsTwenty-three stakeholders participated in the Delphi panel. Forty-four indicators were included as valid after the systematic comparison of similar indicators in other assessment tools. Of the 63 indicators brought to the Delphi panel, 37 were included as valid, 15 were excluded and 11 became criteria for other included indicators.ConclusionsThe study resulted in a set of 81 validated primary care indicators. The validation of the indicators provided a strong foundation for the next version of the Quality Tool and may be used for quality assessment in primary care.© The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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