Data to Decisions: Advancing Primary Care is a membership-wide report on performance in primary care. It helps local teams see where they stack up against their peers on a small number of measures. For teams that are just getting started on their QI journey, it can help set a focus and a goal. No matter where your team is with getting or using data for improvement, D2D is a tool that makes it easier for us all to advocate for what it takes to keep doing the kind of primary care we believe in. Over 100 teams (caring for approximately 1.7 M patients) contributed data on at least 10 core indicators for D2D 2.0.  The report was produced with help of 35+ QIDSS and is available to ALL members Follow links for more information on the rationale for D2D and the process for selecting indicators.

Supporting materials

Videos:

• Why D2D? Video from a family physician’s perspective
• Launch of D2D 2.0 Orientation Webinar 
• Detailed animated tour of D2D 2.0

Quality roll-up indicator: Frequently Asked Questions Documents embedded in D2D For each indicator, there are supporting materials with more detailed information about the

• definition of the indicator
• considerations for interpretation of the data
• suggestions for evaluating and improving data quality
• resources to help with efforts to improve care. 

The materials are intended to be used by any and all staff of member organizations to start conversations with their teams and their peers.  The ideas for actions presented in the supporting materials are just that – ideas!  AFHTO members are at different stages in their performance measurement journey.  For some, the next steps forward are conversations with Board members or clinical leaders to create forums for consideration of quality measures.  For others, the next steps might be attempts to extract EMR data and for still others, the next step might be the implementation of a new clinical program.  The goal of D2D is to support members in taking action wherever they are at with whoever they can to step towards manageable meaningful measurement.  Any step is the right step! Contact information Please contact Carol Mulder, QIDS Provincial Lead, with any questions, comments or suggestions.

Updated as of January 22, 2016 Assuming you have established that the data are good enough to direct action AND that improving performance in this area is a priority for your team, you may wish to discuss the following options with your clinical leaders, Quality Improvement committees, team staff and/or patients:

• Explore interventions to increase proportion of patients with regular care provider and/or interventions to improve continuity of care (i.e. increase the chances that they see the same provider each time)

• • Ask patients what is most important to them: train front reception staff to discuss options with patients as part of the appointment-booking process (i.e. difference in wait times if patient wants to see their regular primary care provider vs. any primary care provider in the team)
  • Improve same day/next day access for all physicians (i.e. ensure all physicians have same day/next day spots available exclusively for their patients).

• Contact your peers to determine their performance and work with them to either spread any processes they find have helped them or collaboratively test some new changes that might work for you AND your peers.

Updated as of January 22, 2016

• Virtual rostering assigns patients to the primary care physician that provided the highest dollar amount of services within a defined set of primary care services. Physicians in your team may not be aware of which patients have been virtually rostered to them and may erroneously think that these patients are not “their” patients. Hence, an individual physician’s sense of how many of the visits they provide are visits to “their” patients may be different than the rate shown in D2D.
• Visits to health care providers other than physicians are not included in this measure. However this does not necessarily skew the measure.  For example, if a patient visits a primary care team 10 times and sees a physician 8 times, and each time it is their “own” physician, they will score 100% (8 out of 8) for “regular care provider – individual”. If, however, they visit 10 times, receiving care from multiple providers but only saw a physician once, they could still score 100% on this measure if the one visit to a physician was to their “own” physician.
• Efforts to improve access to same or next day appointments may result in patients seeing whichever physician is available for appointments at the time. While this may be valuable from the perspective of access, this process may be reflected in poor performance on the “regular care provider – individual” measure.
• Teams with part-time physicians and teaching teams may have developed strong relationships between physicians to jointly care for patients, such that patients may feel equally comfortable and familiar with more than one physician. However, while this might embody team-based care, it may be reflected in poor performance on the “regular care provider – individual” measure.

UNDER CONSTRUCTION – check back soon!