How to use the Quality Book of Tools

The Quality Book of Tools provides a set of indicators and criteria that help the practice reflect on its strengths as well as areas that need improvement (“where you are”). The practice can then focus on actions that over time will achieve that improvement (“where you want to be”).

The Quality Book of Tools is large and its scope ambitious. It can be intimidating, so here are our suggestions for getting started:

  • The book is a compendium of common primary care best practices. It is designed to be used to improve the whole practice, but you can begin that process with a single indicator, ideally in a voluntary assessment program such as the Quality in Family Practice program.
  • Read the introduction to get an overview of the purpose of the book and the different Categories, Sub-Categories, Indicators and Criteria. (Category D: Safe, for example, covers such things as cold chain, infection control, drug management and record-keeping). The book is divided into eight Categories with 34 Sub-Categories and 70 Indicators. Each indicator links to evidence-based websites under the heading Further Information. The up to date links have been collected in a resource database that can be found at
  • Read and reflect on CQI and how to use PDSA cycles to improve quality in your practice.
  • Decide which areas of your practice you would like to improve and in what order. Do you want to assess the whole practice or just certain aspects? Even if you intend to assess the entire practice, you can begin with one area, such as practice management or clinical care.
  • Choose a category and drill down to a sub-category. Once you have decided where you want to focus your attention, start with the indicator most relevant to your practice and review the criteria.
  • Then determine whether you meet the Interpretation. Many practices will find they already meet the requirements for some indicators and criteria.
  • Apply a PDSA approach to any criterion the practice does not meet. Assess where you are and what improvements are needed. Plan the first step needed to get where you want to go. Do that activity, then measure and evaluate whether you have accomplished what you wanted to achieve. If not, repeat the PDSA cycle. Sometimes more than one activity needs to be done before the Interpretation for a criterion can be met.