Author: sitesuper

Indicator: Catchment Area Specific Measurement: Self-described nature of the community the health team is located in (rural vs urban) Source definition: AFHTO Data Source: Direct report by teams via D2D data submission form Data Access Notes:

Indicator: Patients rostered Specific Measurement: Number of patients formally rostered to the team Source definition: n/a Data Source: Direct report by teams via D2D data submission form Data Access Notes:

Specific Measurement: The percent of enrolled patients with an acute inpatient hospital stay for selected conditions who see their primary care provider or any primary care provider in the group they are enrolled with within 7 days of discharge. Conditions include: cardiac conditions (excluding heart attack), congestive heart failure, Chronic Obstructive Pulmonary Disease (COPD), pneumonia, diabetes, stroke and gastrointestinal disease. http://www.health.gov.on.ca/en/pro/programs/ris/docs/patients_with_primary_care_visit_within_7_days_of_discharge_qips_primary_care_en.pdf Source definition: MOHLTC RIS Data Source: Health Data Branch portal https://hsimi.on.ca/hdbportal/ Data Access Notes: Extract data from QIP data sheet available to all teams via HDB

Indicator: 7-day follow-up – team specific indicator Specific Measurement: The % of eligible patients followed up in an appropriate manner within 7 days of discharge from hospital (accompanied by team specific description of eligibility and appropriateness). Source definition: AFHTO Data Source: Team-defined Data Access Notes: Teams submitting data must include description of their process and definition

Updated as of January 22, 2016 Please see PAGE 19 of the D2D 3.0 Data Dictionary VERSION 4

Updated as of January 22, 2016 Please see PAGE 15 of the D2D 3.0 Data Dictionary VERSION 4

Updated as of January 22, 2016 Please see PAGE 11 of the D2D 3.0 Data Dictionary VERSION 4

Updated as of January 22, 2016 Please see PAGE 14 of the D2D 3.0 Data Dictionary VERSION 4