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Participating in the quality roll-up indicator (beyond core D2D 2.0 indicators)

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WHY: To prepare your team to contribute data to the quality roll-up indicator. WHAT: If you choose to opt in to calculating your quality roll-up indicator this can be done with your core D2D 2.0 indictors. If your team has the resources and information readily available you may also choose to participate in the expanded data submission for the quality roll-up indictor.

  • See Quality ‘roll-up’ indicator for more information about the purpose and structure of the indicator.
  • Review list of additional data (see table on next page) which can be submitted for the expanded data submission of the roll-up indicator.   They are organized according to data source.  The high-priority indicators (beyond the core D2D 2.0 and ICES data indicators) are shown in bold italics.  The lower priority indicators are the remainder in normal type-face.

 

Additional Data for Expanded Data Submission for Quality Roll-up Indicator     
  • Core D2D 2.0 indicators:
    • Readmissions to hospital
    • Regular care provider – individual
    • 7-day follow-up
    • Cervical cancer screening
    • Colorectal cancer screening
    • Reasonable wait for appointment
    • Data from ICES
      • Ambulatory care sensitive hospitalizations
      • Emergency department visits
      • breast cancer screening
      • diabetic management and assessment
    • Health Data Branch portal
      • Emergency department visits for conditions best managed elsewhere
    • Data from EMR
      • Review of registries of specific chronic  conditions
      • reconciliation of diagnoses
      • medication reconciliation 
      • Diabetic  blood sugar management
  • Coumadin management
  • Hypertension screening
  • Diabetes screening
  • Diabetic cholesterol management 
  • Influenza immunization
  • smoking status
  • Direct input from team
    • direct office access
    • Primary care record included in hospital admission record
    • 24/7 coverage for palliative patients
    • 24/7 coverage for long-term care patients
    • Patient experience survey data
      • Personal problems related to health condition
      • Opportunity to ask questions
      • Spend enough time
      • Find out your concerns
      • Say what was important
      • Take your concerns seriously
      • Concerned about your feelings
  • Determine how much of that additional data is available, how much effort it would be to access it and the potential increased reliability of the roll-up indicator.  See Figure 1 (below) to estimate the incremental increase in reliability with additional data entry.  Reliability is measured with a statistic called Cronbach alpha, the most important characteristic of which is that higher values are better.

Reliability of Roll-up Indicator

Figure 1: Reliability of roll-up indicator (source: Patients Canada survey, n= 200, pat weights 4.sav) Figure 1 shows that the roll-up indicator has some reliability even with just core D2D 2.0 indicators (0.587).   This increases to 0.697 with the addition of the ICES data from the expanded set of measures listed below.  Since these additional indicators are already available to any team that has requested ICES data for D2D 2.0, contributing them may generate increased value in the roll-up indicator without much additional effort.  The reliability of the roll-up indicator increases to 0.846 with the addition of the “high priority” indicators listed below.  This increase in reliability may need to be balanced by the extra effort associated with getting access to these data.  Contributing data from the lower-priority set of indicators does not increase reliability much at all (i.e. increase to 0.855), something teams might weigh against what might be considerable extra effort to access and contribute these data.

  • Consult internally with the most appropriate member(s) to decide if your team is interested in contributing to the quality roll-up indicator.
  • Compile data for the additional indicators your team is able to contribute.
  • Set data aside for submission to D2D 2.0 (see data submission guide).

WHEN: May 19 – June 1, 2015

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