A rural approach to quality improvement for small rural hospitals: Lessons from rural Texas.

This article describes the Rural Physician Peer Review Program (RPPR©) developed by the Texas A&M Rural and Community Health Institute and presents it as an example of a program that could be implemented in rural Canada as an effective means of continuing professional development (CPD) for rural Canadian physicians. RPPR© post review survey responses from 574 physician participants across rural Texas indicate that they are highly satisfied with RPPR© and that their competency in medical knowledge and patient care improves as a result of participation. A pilot project with two to four northern Ontario hospitals would enable RPPR© to be modified to ensure applicability and feasibility in the northern Ontario context to create an RPPR© "North." New and innovative approaches to CPD for rural northern physicians need to be continually explored to decrease professional isolation, improve recruitment and retention, and ultimately improve the quality and safety of healthcare in rural areas.