The Quality Book of Tools is a key feature of the Quality program for voluntary assessment by trained peer assessors in family practices in Ontario. The Quality program team (a collaborative group from McMaster University and the Ontario College of Family Physicians), funded by the Ontario Ministry of Health and Long-Term Care since 2003, developed and tested the program and the original Quality Tool in a number of phases. In 2003-2005, the team reviewed the national and international literature on quality assessments in family practice/primary care, conducted focus-group interviews, environmental scans and teleconferences with patients and practitioners, and visited sites in the United Kingdom, Australia, New Zealand and Toronto, Canada that operate quality programs. The information guided the process for the Quality program and tool development. The project team was assisted by a steering committee composed of primary care providers, administrative staff and patients/consumers, a number of consultants and an advisory committee of key stakeholders. The program and tool was tested in three practices in urban and rural settings in Ontario in 2005-2006, and in seven family health teams (including 130 health-care providers caring for 74,000 patients) in 2007-2008.
A modified Delphi process, conducted in 2008-2009 on the Indicators, led to a complete rewrite of the Quality Tool in 2009-2010. The revised version is called The Quality Book of Tools and covers the complex scope of family practice.