Ultimate Blogging Championship

Author: sitesuper

  • Diabetes – Potential actions related to processes of care

    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:

     

  • Diabetes – Technical notes

    Please refer to PAGE 21 in the D2D 3.0 Data Dictionary VERSION 4  

  • Diabetes – Data quality actions

    Estimate the impact of data quality

    • Access the Imperfect Data Impact Calculator to find out whether the data quality issue(s) you think you have would change your initial decision regarding the need to improve.
    • Please see below for more information about this tool.

    Increase the quality of the data

    …if the “imperfect data impact calculator” shows that the issues in your data may point you to a different decision than suggested in D2D 3.0. You might consider the following:

    • Increase awareness of your team about the importance of having “clean” data in your EMR: Project ALIVE shows that having clean data in your EMR allows you to create quick and flexible reports to better inform your team about the needs of patients and which patients require follow-up care.
    • Create a diabetes registry: identify patients with diabetes more accurately using the standard queries and processes developed by QIDS Specialists to get started on a diabetes registry
    • Track and demonstrate your progress cleaning up your data to improve data quality. Before you start the cleanup process run a “coded” query to capture a baseline, then every few months re-run the query and plot your results over time. You may want to use a tracking form to help you document your progress.
    • Consider hiring a student to help you clean up your diabetes data. Check page 26 in this handbook for details about cleaning up diabetes data.
    • Once your diabetes registry is clean, run the D2D diabetes queries on an ongoing basis – don’t just wait till the end of the year. Do you notice any changes?
    • Consider signing up for CPCSSN or EMRALD to get ongoing, patient-specific reports to help you help your patients manage their diabetes.
    • Join an EMR CoP to share new tools and solutions to help you make better use of your EMR.

    Additional  information for estimating the impact of data quality for this measure:

    The data are almost certainly not a definitive estimate of your team’s actual performance. However, they might be “good enough” to help you decide if your team needs to improve or not. To determine if the data are “good enough” for that, estimate how likely it is that one or more of the issues outlined in the interpretive notes are a problem with your team. Then, run the “imperfect data impact calculator” to see if the issue(s) could lead to a different decision related to the need for improvement. To do this, work with your clinical leaders and staff to establish an approximate impact of data quality – i.e. is the data quality issue causing your performance to look like TWICE or HALF or 10% (or other number) less or more than it actually is? Plug that number into the “imperfect data impact calculator”. It will show you whether the data quality issue(s) you think you have would change your initial decision regarding the need to improve. Click here to access the Imperfect Data Impact Calculator. You may find it hard to generate consensus about the impact of data quality issues on the level of performance shown in the D2D 3.0 report. In that case, consider the following options:

    • Track the next 10 (or 20 or other small number) encounters to get a better estimate of the extent of the data quality issue. Perhaps the rate among these patients will shift your team’s overall rate to be TWICE or HALF or 10% (or some other number) of the rate in the report. Plug that number into the “imperfect data impact calculator” and proceed accordingly.
    • Estimate how many of your patients with diabetes have blood pressure (or HBA1c) recorded properly in the EMR. Perhaps the rate among these patients will shift your team’s overall rate to be TWICE or HALF or 10% (or some other number) of the rate in the report. Plug that number into the “imperfect data impact calculator” and proceed accordingly.
    • Estimate how many of your patients with diabetes are not coded in a consistent manner in your EMR. Perhaps the rate among these patients will shift your team’s overall rate to be TWICE or HALF or 10% (or some other number) of the rate in the report. Plug that number into the “imperfect data impact calculator” and proceed accordingly.
    • If none of the above is helpful, consider instead experimenting with possible “error” rates to see how much error (i.e. TWICE or HALF or 10% of some other number) would be needed to change the decision made on the basis of the performance of the indicator in D2D 3.0. If, in the opinion of the team, such an amount of error is reasonable, then it may be worth considering efforts to improve data quality. Alternatively, if that amount of error is considered to be unlikely, then the data are likely good enough to support the initial decision regarding the need to improve, based on the performance shown in D2D 3.0.

    If the “imperfect data impact calculator” points to the same decision (e.g. a need to improve or NOT) even after data quality issues are considered, the data are likely “good enough” to base your decision on regarding the need to improve. The next step is to consider strategies to improve, assuming the area of care measured by the indicator is a priority for your team.  If your data are not “good enough”, you may then consider taking action to improve your data quality, before or at the same time as you try to improve processes of care.  

  • Diabetes – Interpretive notes

    • The Diabetes Care Score represents the % of diabetes measures (aspects of care) that a team’s patient population has achieved. For example, if your team’s score is .68, this means that your population or registry of patients with diabetes has achieved 68% of the 3 measures included in the calculation (HbA1C testing, HbA1C level and blood pressure level). In future iterations of D2D, the composition of the indicator will be modified to include other measures of diabetes care like foot and eye exams, based on increasing EMR maturity/data quality and capacity to access data on personalized targets.
    • Your score may be low if you have a lot of patients with diabetes that have only one process/outcome measure within the appropriate target.
    • Your score may also be low if you have patients with no measures in range, even though others have most of the measures in range.
    • How you document and are able to access blood pressure and HBA1c data in your EMR will affect the numerator i.e. your score will be low if documentation is an issue for your team.
    • The way your team documents diabetes diagnoses in the EMR affects your denominator (i.e. number of patients with diabetes). Your diabetes score may be over or understated depending on how “clean” your diabetes registry is.

  • Register Now – Annual Operating Plan & Privacy Webinars

    REGISTER NOW: A joint webinar between AFHTO and the Ministry will be offered to review the Annual Operating Plan (AOP) timelines and expectations, with a specific focus on the Program Planning & Evaluation Framework, Indicator Catalogue and Schedule A reporting requirements for FHTs.

    (Note: the webinar is being offered twice to provide flexibility & maximize participation. Please register for one session only. In the event that you cannot attend, the webinars will be recorded and available on AFHTO website)

    √  Annual Operating Plan (AOP): AFHTO is anticipating Ministry release of the AOP to FHTs/NPLCs by the first week of February. Expected submission deadline is mid-April.

    √  Program Planning & Evaluation Framework: developed jointly between AFHTO member ED Work Group and the Ministry, the framework is intended to be a guide for FHTs and NPLCs to use when developing new or evaluating current programs, and to help promote the delivery of effective programs. The Framework will be a valuable reference to support teams in completing their program reporting requirements. (will be shared end of January)

    √  Indicator Catalogue: the indicator catalogue is another supportive guide developed for FHTs/NPLCs to use when selecting meaningful measures for their programs that are based on clinical guidelines. The catalogue will enable teams to find sample indicators that can be used to measure progress on specific objectives and select indicators that align most appropriately with the goals of their programs. (will be shared end of January)

    Privacy Webinar: Reminder – FREE Privacy Training & Tools
    To assist our members in meeting and understanding the new privacy criteria set out by Office of the Information and Privacy Commissioner of Ontario , the following FREE training and tools will be made available:

    •  A 1hr Privacy Training Webinar for Executive Directors – 12-1pm WEDNESDAY JANUARY 27th 2016 – click here to register
    • A 1hr Privacy Training Webinar for Board Chairs – 12-1pm WEDNESDAY FEBRUARY 3rd 2016   –  click here to register
    • Privacy Tools: to answer the top 5 privacy questions asked by FHTs/NPLCs and FHT/NPLC staff  – tools/templates to be released end of JANUARY 2016

  • Greg Manage QRU

    [manage_data]

  • Member News: relevant updates, patient engagement resources and learning opportunities

    Below are relevant updates and items for AFHTO members, including free training and new reports:

     Updates Relevant to Primary Care

     Patients: Outreach Initiative and Information to share

      Events and Learning Opportunities
    • Feb. 1, 2016, Webinar on Bariatric Surgery: last of a 3-part series, this webinar will review advanced bariatric nutrition. Past webinar recordings and materials are posted online.

  • Budget Talks 2016: ask the Ontario government to address recruitment and retention

    The Ontario government has opened Budget Talks 2016, an online portal for Ontarians to offer feedback to the government on 2016/17 budget planning, which provides another opportunity to raise awareness of the need for sufficient funding for recruitment and retention. Use this opportunity to continue the call to support recruitment and retention in primary care teams by voting or commenting on the portal. If you’d like resources to assist you, click here (log in to the Members Only section first.)

  • Statistics Canada recruiting for 2016 Census

    The next mandatory census will take place in May 2016 and Statistics Canada will be hiring approximately 35,000 people across the country to assist in its collection. As such, members are asked to post the documents below in their waiting rooms so patients are made aware of these job opportunities.

    Update : Community Supporter Toolkit– products and resources to help you and your organization spread the word about the benefits and positive impact of the census on your community. Additionally, members are also encouraged to complete the census to have a direct impact on gathering the data needed to plan, develop and evaluate relevant programs and services. Census information is important for all communities and is vital for planning services such as schools, daycare, family services, housing, police services, fire protection, roads, public transportation and skills training for employment.

  • D2D data submission closes this Friday!

    Deadline to contribute data to D2D 3.0 is this Friday, January 15, 2015.  ALL AFHTO members are welcome to contribute, whether or not you’re one of the 125 AFHTO teams who have already signed up.

    If your team is already well underway with your submission, that’s great! If, on the other hand, you want help or have questions, please contact Greg.Mitchell@afhto.ca.

    Please see the D2D Planning and Preparation page for additional information to help you in the data submission process.  Thank you for your interest in D2D 3.0 to date. We are looking forward to sharing the results on February 1st. Click here to register for one of the orientation webinars.