Jan. 8 – Health Quality Ontario has released reports summarizing the quality improvement plans (QIPs) submitted this year by health care organizations across Ontario. The Insights into Quality Improvement – Key Observations: 2014-15 Quality Improvement Plans are reports that span acute hospitals, inter-professional primary care organizations, home care, and long-term care and are part of HQO’s new quality improvement plan report series highlighting emerging trends, lessons learned, and opportunities for quality improvement across Ontario’s health sectors. This is the second year that inter-professional primary care organizations submitted QIPs. The primary care report provides information on what providers in Ontario are focusing on to improve quality of care, what change ideas may lead to improvements in future years, and where there may be opportunities to learn from others.
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Data to Decisions (D2D) ebulletin #2
This is the second issue of the Data to Decisions (D2D) eBulletin. It will be released biweekly to keep members up-to-date on using manageable and meaningful measurement in your work, and how to participate in Data to Decisions 2.0 (D2D 2.0), tentatively planned for May 2015. The first issues of the bulletin will be sent to all AFHTO member contacts to allow members to judge whether they want to sign up to receive the bulletin on an ongoing basis. Please forward the eBulletin to interested members of your team. We will be introducing the “sign-up” process for this eBulletin in the next issue. In the future, only those who “sign-up” will continue to receive the eBulletin. In the meantime, if you have any comments or questions about the eBulletin, please let us know by e-mailing improve@afhto.ca.
Data to Decisions eBulletin #2 – Jan 8, 2015
Data to Decisions (D2D) is a member-wide summary of performance on indicators that are both possible for members to measure and that are meaningful to members. D2D 2.0 is the second iteration of the report. See the D2D page on AFHTO’s web site for more information about D2D and manageable meaningful measurement. See below for updates about D2D and opportunities for you to be part of the process. The bulletins will be released every other Thursday. They will capture important developments emerging from the AFHTO members across the province and shared through the weekly QIDS Specialist web conferences. Past issues will be posted on the QIDS Program page of AFHTO’s members only web site to make it easier for you to find all the relevant information related to D2D in one place. For more information, please contact improve@afhto.ca
Contributing to D2D 2.0
REMINDER!! Complete the indicator selection survey by Jan 23, 2015. Please review the instructions for working with your team to provide input about which indicators should be included in D2D 2.0. The survey was released Dec 15, 2015 and is due Jan 23, 2015. Preliminary data dictionary for D2D 2.0: Please check out the preliminary data dictionary describing potential indicators for D2D 2.0. It is now posted on the D2D web page. Indicators Working Group meeting Jan 13, 2015: The group will discuss D2D report design and communication strategies among other things.
Using D2D 1.0 to improve data quality and care
Custom Query to extract data from forms in PS: A large and growing proportion of teams using PSS are taking advantage of this new data extraction functionality developed through the East Wellington FHTs Innovation Project. The query is simple to use and can be installed without cost. Click here for details Custom Queries details. To register for installation or get further information, please contact Marg Leyland.
Other news about manageable meaningful measurement
Leadership opportunities: the call for volunteers closes TOMORROW (Jan 9, 2015)! Please consider volunteering for one of the leadership roles in advancing manageable meaningful measurement. QIP Reports now available online: Health Quality Ontario has just released reports summarizing the quality improvement plans (QIPs) submitted this year by health care organizations across Ontario. Click here for the primary care report and click here for additional QIP resources. Patient-doctor partnership composite indicator development: Patients Canada will be working with AFHTO over the coming weeks to contribute patient input to the patient-doctor partnership composite indicator, one of the core components of meaningful measurement aligned with the Starfield principles. See project outline or contact Puja Ahluwalia for more details
What do you think?
We will be introducing the “sign-up” process for this eBulletin in the next issue. Please forward the eBulletin to interested members of your team. In the future, only those who “sign-up” will continue to receive the eBulletin. In the meantime, if you have any comments or questions about the eBulletin, please let us know by e-mail to improve@afhto.ca.
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Cancer screening resources for family health teams and for newcomers to Canada
AFHTO is making the information below available to all AFHTO members on behalf of Cancer Care Ontario:
- Cancer Screening Resources for Newcomers and Immigrants– developed for reaching under-/never-screened populations
- Interactive Cancer Screening Report Accessible to Multiple Team Members– the Screening Activity Report (SAR) has been enhanced. Click on the link to see its benefits for a FHT (including an interview with Dr. Marla Ash, North York FHT.)
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Seasons greetings from AFHTO
Wishing a joyful holiday to you, your family and community! -
Introducing the Data to Decisions (D2D) ebulletin
This is the first issue of the D2D ebulletin. It will be released biweekly to help members and AFHTO staff keep track of everything everyone has to do and know to produce Data to Decisions 2.0 (D2D 2.0), tentatively planned for May 2015. Today’s public release of the FHT evaluation report underlines the importance of our collective work to use data to measure and improve, and demonstrate the value delivered by interprofessional teams providing comprehensive primary care. The ebulletin will give updates and reminders for key dates and activities on the following topics:
- Contributing to D2D 2.0
- Using D2D 1.0 to improve data quality and care
- Other news about manageable meaningful measurement
The initial issues of the bulletin will be sent to all AFHTO member contacts to allow members to judge whether they want to sign up to receive the bulletin on an ongoing basis. The process for signing on to the distribution list will be outlined in a subsequent issue.
Data to Decisions ebulletin #1 – December 18, 2014
Data to Decisions (D2D) is a member-wide summary of performance on indicators that are both possible for members to measure and that are meaningful to members. D2D 2.0 is the second iteration of the report. See the D2D page on AFHTO’s web site for more information about D2D and manageable meaningful measurement. See below for updates about D2D and opportunities for you to be part of the process. The bulletins will be released Thursday afternoons to synchronize with the weekly QIDSS calls and thus provide the most up to date information possible. Past issues will be posted on the QIDS Program page of the AFHTO members only web site. We hope this will make it easier for you to find all the relevant information related to D2D in one single place. For more information, please contact improve@afhto.ca
Contributing to D2D 2.0
Things to do Participate in the indicator selection process: Complete the survey by Jan 23, 2015. Please review the instructions for working with your team to provide input about which indicators should be included in D2D 2.0. The survey was released Dec 15, 2015 and is due Jan 23, 2015. Things to know Tips and Tricks to increase consistency of clinical EMR data entry and extraction: Cancer Care Ontario (CCO) is sponsoring 4 regional sessions with QIDSS to increase consistency of entry and extraction of clinical data related to cancer and associated chronic conditions. In addition, QIDSS and the EMR Data Management subcommittee are working on strategies to increase access to data for 7-day follow-up, data quality and other clinical indicators. Want to know more? Please contact your QIDSS, Carol Mulder (carol.mulder@afhto.ca) or Kevin Samson (kevin.samson@ewfht.ca), chair of EMR DM subcommittee. D2D 2.0 consultation activities conducted to date: In addition to ongoing input from QIDSS and members, input on D2D 2.0 was sought from the Advisory Panel, the QIDSS host EDs and Patients Canada.
Using D2D 1.0 to improve data quality and care
Things to do How to get team-level ICES data: Teams can access team-level data through the HQO portal with the collaboration of at least one doctor on their team. HQO will be making team-level data available directly to EDs likely by the end of the 14-15 fiscal year (i.e. in time for D2D 2.0 submission). How to get drill-down data for D2D 1.0 “cost” indicator: All teams who requested data from ICES for D2D 1.0 can access drill-down detail on the cost of care indicator from ICES by contacting Rick Glazier. The deadline for the original D2D 1.0 request is past. If you didn’t make the June 2014 deadline, you will not be able to access cost data at the moment. However, you can prepare to request these data for D2D 2.0. Please see request form for information about what permissions are needed. Things to know QIDSS ongoing professional development: In addition to the CCO-sponsored regional sessions on EMR data entry and extraction, QIDSS are meeting in January for a full day professional development session to share and learn about helping clinicians use D2D to improve data quality and/or care.
Other news about manageable meaningful measurement
Things to do Leadership opportunities: consider volunteering for one of the leadership roles in advancing manageable meaningful measurement. Things to know Starfield framework development: Welcome Puja Ahluwalia, who joined the AFHTO team as coordinator for this project. See the high-level project description for more details. HQO’s Primary Care Performance Measurement Framework: The prioritization of system-level indicators is near completion. Input from and alignment with D2D figured prominently in the process, resulting in overlap of 7 of 10 indicators which were relevant for practice-level reporting. Watch future bulletins and/or HQO’s site for more information about the prioritization process. Towards the next ministry contract: AFHTO members have indicated they want to have their accountability to the ministry defined in terms of collectively agreed upon measures that reflect value delivered. The ministry has said it is looking to AFHTO, in collaboration with other relevant stakeholders, to recommend performance measures. We are well-positioned to do this, by leveraging our collective work on D2D 2.0. HQO Measuring Up: When compared to the performance of primary care providers across the province reported in HQO’s Measuring Up report, D2D 1.0 shows that AFHTO members are performing well on several of the indicators included in both reports. This is encouraging! Quality Improvement Plans: QIP navigator has been launched by HQO. QIDSS will be meeting in early 2015 to share strategies for using D2D process in QIPs.
What do you think?
You will receive several more D2D bulletins before you will be asked if you want to sign up to continue receiving it. We look forward to hearing from you about if and how this D2D bulletin is working for you!
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Preparing for a busy influenza season
Dec.17- AFHTO forwarded the following information to all AFHTO members on behalf of the Chief Medical Officer of Health: Please see the memo regarding recommendations in response to current influenza activity, including circulation of potentially mismatched influenza A/H3N2 strains. For more information, please contact your local public health unit. Visit the ministry’s website to locate your local public health unit. French translation of this memo will be distributed in the coming days.
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Indicator Selection for Data to Decisions (D2D 2.0) – survey deadline Jan 23, 2015
It’s D2D time again! We’ve made a list – we’d like you to check it twice! Please provide your input into the selection of indicators for the second iteration of Data to Decisions (D2D 2.0). We would like to finalize the list early in the new year to give everyone as much time as possible to get the data and pull the report together. To that end, please complete the survey by Jan 23 2015. What is D2D 2.0? Data to Decision 2.0 is AFHTO’s way of “keeping going” in the journey to advance manageable meaningful measurement. It is the second iteration of a membership-wide report summarizing performance on indicators that are both possible for members to measure and that are meaningful to them. It follows the lead of D2D 1.0, which was AFHTO’s attempt to “get started” on this journey (see FAQ for more background on D2D 1.0). “Keeping going” is different than “getting started”. For example, the goal this time is to get as many teams as possible contributing data. This is partly to ensure that all members have equally good opportunities to use the report to fuel their own local efforts to improve quality. It is also important to ensure that the results are truly representative of AFHTO members as a whole. And finally, it is critical to making sure that the new ministry contract focuses on measures that matter to members. Input from the MOHLTC suggests they are very open to the idea of using D2D 2.0 as a basis for this contract, assuming it represents the vast majority of members. Where did the short-list of indicators come from? The short list of indicators for D2D 2.0 is based on input from an advisory panel of clinicians and EDs, the QIDSS host ED forum, Patients Canada and consultation with members regarding the new Ministry contract as well as ongoing informal input from members before, during and after the release of D2D 1.0 in a variety of forums. The list is also heavily influenced by the recent work to prioritize the long list (i.e. 200+) of indicators in the PCPMF. The criteria for selecting indicators that emerged from this input is as follows:
- Be part of D2D 1.0 unless there is a clear indication against including them again
- Address a clear and important-to-members gap among D2D 1.0 indicators
- Be possible for majority of AFHTO members to access data with reasonable effort
- Align as much as possible with sector wide reporting processes/capacity (i.e. to facilitate inter-model comparisons)
- Be among the top-weighted indicators in the Starfield Primary Care Index (to extend capacity to measure quality of comprehensive, patient-centered care aligned with patient expectations)
What is the short list of indicators? There are 3 groups of indicators for members to provide input on.
- Existing D2D 1.0 indicators: All of the D2D 1.0 indicators will be retained in 2.0 unless there is clear evidence that it is not possible for a large proportion of AFHTO members to do so in a consistent way. The definitions and data capture processes for some indicators have been modified to address concerns raised about feasibility and data quality in the D2D 1.0 process.
- Potential additions for D2D 2.0: Several indicators are proposed to fill perceived gaps in coverage in D2D 1.0. The specific rationale for each indicator is provided in the survey materials. Only a small number of candidates are offered for input, given the very clear guidance against having large numbers of indicators.
- Context indicators: In addition to the “peer group” characteristics included in D2D 1.0 (i.e. roster size, rurality and EMR access to hospital discharge data), several other indicators (e.g. teaching status) are proposed to make it more meaningful for teams to compare to peers.
See survey instructions for detailed list of indicators. How do AFHTO members provide input for indicator selection?
- Find out what your team thinks about the indicators: You may choose to ask your Board, your Quality Improvement committee, your physician group and/or your staff about what indicators matter most to them. If you want to do a local “first round” of the survey, we have a provided a mechanism for that. We have also provided a short handout about D2D 1.0 in case that helps start the conversation. See survey instructions for more details.
- Complete the survey by Jan 23, 2015: You can complete the survey as an individual or as a group. Just indicate how many are in your group when you do, so we can account for that in the results.
- Talk to us! Contact Carol Mulder (carol.mulder@afhto.ca), any QIDSS or member of the Indicator working group. All of these people are actively involved in the actual implementation of the report so they can give you more background and/or bring your comments forward.
- Take the lead! AFHTO has is asking for members to volunteer for a variety of leadership roles related to advancing manageable meaningful measurement. One of the newest of these is the Physician Leadership Council. More information will be forwarded to all members soon. In the meantime, please consider these opportunities for you to provide further input.
How do we find out more? AFHTO will be launching a regular bulletin to better share emerging news about advancing manageable meaningful measurement. Watch for this coming soon to your inbox. In the meantime, please check out the D2D page or contact Carol Mulder (carol.mulder@afhto.ca) for more information.
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St. Michael’s Academic FHT’s income security project profiled in the Toronto Star
Dec. 15 – St. Michael’s Academic Hospital FHT was profiled for their work addressing patients’ income security in the Toronto Star. Dr. Andrew Pinto and Karen Tomlinson (both of whom presented on this project at AFHTO’s 2014 conference) along with Dr. Gary Bloch were all recognized for their innovative focus on one of the key social determinants of health. Click here for further details.
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Data to Decisions 2.0 Indicator Selection Survey instructions
D2D 2.0 Indicator Selection Survey Instructions 1) Set a date for your team to provide input: Some teams choose to get input from their Board, their QI committee, their physicians and/or their staff. Decide if or how you are going to do that so you can set up the date far enough in advance to meet the survey deadline of Jan 23, 2015. 2) Review the proposed indicators: see table below. NEW: See Data Dictionary for D2D 2.0 indicators. 3) Assemble the input from your team: Some teams prefer to run a “first round” of the survey within their teams prior to submitting their “vote” to AFHTO. See notes below for suggestions on this. 4) Complete the survey: Submit your team’s votes by Jan 23, 2015. Be sure to indicate how many people your vote represents (ie just yourself? A group of 4 board members? 10 physicians? Etc.). 5) Watch for the final list: This will be announced early in Feb, 2015 to allow as much time as possible for data extraction and submission to D2D 2.0.
Background information on the indicators See table for the indicators to be considered in the survey (See also below for the list of indicators). The table includes the working name and working definition of the indicator. In some cases, the exact details are pending the work of the QIDSS and other efforts to improve either the definition or the process for data capture, based on learnings from D2D 1.0. The comments about data definition and capture describe work that is either already complete or in progress to resolve concerns about both the definition of the indicators (meaningfulness) and the ability to capture it (ie manageableness). If the work is not completed in time for data extraction, then the indicator will not be included in D2D 2.0, even if it surfaces as a high priority through the voting process. Teams are being asked to comment on their interest in the indicators based on the working definitions and their confidence in their ability to extract the data by late March or early April, 2015, given the ongoing work to improve access to the data. As is shown in the table, there were attempts to align the indicators with D2D 1.0, PCPMF, Starfield and input from patients and members. Not all indicators align entirely. Members are asked to vote on the indicators, given this knowledge. Finally, the table includes general comments about the rationale for proposing the indicator for D2D 2.0. These comments are a synthesis of input from a variety of sources. Not all indicators generated equal amounts of commentary so the extensiveness of the rationale varies between indicators. These comments are based on input to date and may change based on the results of the voting. List of Indicators (See table for background) D2d 1.0 indicators- Cost
- Patient experience
- Childhood immunization
- Flu immunization
- Colorectal screening
- Cervical screening
- Regular care provider
- Same/next day
- Readmission
Additional indicators for D2D 2.0
- Appointment when wanted
- Phone access
- Patient email addresses
- 7-day follow-up
- Diabetic process or outcome measure
- Satisfaction with receptionist
Context indicators
- Teaching status
- Access to hospitalization data
- Data quality
- Physician and NP FTE
- Hours of service
For more information see the D2D 2.0 data dictionary. Local “first round” to get team input Teams that want to do a “first round” of the survey internally prior to submitting their votes to AFHTO have several options. 1) Local surveymonkey version: Teams that have a “pro” version of surveymonkey (ie any level of paid subscription) can launch the AFHTO survey in their own account and get their own results locally. They then can complete the AFHTO survey to “submit” the team’s results. To do this, teams need to send their surveymonkey account name to improve@afhto.ca so we can copy the survey to your account. 2) Excel version: Teams that do NOT have a paid subscription to surveymonkey can use the attached Excel template to record and compile the votes of members of your team. These data can then be entered into the AFHTO survey to “submit” the team’s results. 3) Manual version(Print): Teams that prefer a paper-based approach can print and share this pdf file and then compile the results manually to enter into the AFHTO survey to “submit” the team’s results. 4) Real-time discussion and data entry: Teams might convene a group discussion to vote on the indicators. Teams may want to use the videos from the launch of D2D 1.0 and/or the handout about D2D 1.0 in addition to these instructions to fuel the conversation. They can then enter the decision about each indicator into the AFHTO survey in the course of the discussion. Weighting of survey results Regardless of the option selected, any number of responses can be submitted to the AFHTO survey. Members are just asked to indicate the number of people that their response represents. For example, if the team chooses option 3 (manual), they would indicate on the AFHTO survey how many people completed the paper vote. If they choose option 4, they would indicate how many people are involved in the discussion. And if they are completing the survey on their own (ie without doing a “first round”), they would indicate that the response represents only 1 person. In this way, the results of the survey can be weighted according to the number of people contributing to each response. The survey The survey is estimated to take about 10 minutes (not including any discussion or first round processes you undertake). The survey includes an opportunity to share comments, concerns, questions and suggestions. The survey results will be considered by the Indicators Working Group along with input from the other consultation processes described above. The final list for D2D 2.0 will be shared with members in early February to ensure enough time to extract data prior to the submission deadline tentatively planned for April.