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  • D2D 3.0 Data Dictionary

    The data dictionary version 4  describes indicators for D2D 3.0 and includes some changes from the initial set of indicators reported in D2D 1.0 and D2D 2.0. The definitions and data sources for these indicators are based on the Primary Care Performance Measurement Framework (PCPMF) wherever possible.

    Although the goal is to not have multiple versions of the data dictionary, it is inevitable that there will be at least one update in the future to incorporate the finalized expanded indicators. To ensure that you have the most updated version, please clear your cache before opening the PDF.

    Please ensure that you are working with Version 4 of the data dictionary.

    For help in data extraction and submission, please contact local QIDSS or the provincial QIDS program staff via carol.mulder@afhto.ca.

  • Decisions from Data: Progress from D2D 1.0 to 2.0

    Summary of the Report

    These analyses summarize progress of AFHTO members in their journey to advance manageable meaningful measurement, largely as represented by Data to Decisions.  Data to Decisions (D2D) is a summary report of performance on a small number of measures that AFHTO members identified as being meaningful and possible to measure.

    Comparison of D2D 2.0 to 1.0: Highlights

    AFHTO members have made big progress in using data to measure and improve performance since October 2014 when D2D 1.0 was released.

    • Team Characteristics: There are better scores on team climate and changes in goal orientation
    • EMR use: There is increased data standardization despite no change in EMR functionality
    • Quality Improvement (QI) activity: There are more frequent conversations with physicians and boards about QI and performance
    • Physician ambassadors: There is a higher awareness of them and an association with increased QI activity and better team characteristics
    • Performance: There is no change in performance on the core D2D indicators from 1.0 to 2.0, which is not surprising since much of the data is from 2013-14 (i.e. before the release of D2D).

    Next steps: DECISIONS from DATA

    Section 4 presents a complete list of decisions for action based on the data analyzed herein. The actions cover topics such as:

    • Team characteristics: Identify factors and strategies contributing to team climate changes and physician ambassadors that could be spread to more teams
    • EMR use: Develop additional mechanisms to increase EMR functionality and expand data standardization
    • QI activity: Create even more conversations about QI and performance, especially with physicians and Boards
    • Performance: Track progress over time.
    • General: Increase participation in D2D and related surveys.

    Data sources

    This report is based on data from the first iterations of D2D (i.e. D2D 1.0 and 2.0) and the first iterations of the pre-D2D surveys (i.e. prior to release of D2D 1.0 and 2.0) as well as a survey of QIDS specialists after the release of D2D 1.0.  Approximately half of the membership participated in the D2D 2.0 with about one quarter to one third contributing to D2D 1.0 and the ED surveys, respectively.  Response rate for QIDS specialists was nearly 90%.

  • Historical Data: Review your data here

    You can view the data submitted by your team for D2D 1.0 and D2D 2.0. Enter your team code below and select which reporting period you would like to view. [input_data]

  • Data to Decisions eBulletin #17: AFHTO making progress since D2D 1.0

    We have made progress since D2D 1.0! Decisions from Data: Progress from D2D 1.0 to 2.0 report takes a look at our journey to advance manageable meaningful measurement.

    Make sure D2D makes clinical sense: Click here to join the conversation with fellow clinicians and/or see progress on development of indicators for ED visits, follow-up after hospitalization and more. The COPD query to build a registry from your EMR can now be run on OSCAR – in addition to Accuro and Telus PS! New! View all your D2D data on the new D2D Historical Data webpage (NOTE: This page is temporarily disabled while we prepare for the launch of D2D 3.0, coming on December 3). You can view the data submitted by your team for D2D 1.0 and D2D 2.0. Spreading knowledge: Has your team found something that works in using data to improve? Drop us a line so other teams can learn with and from you. Help spread the word. Invite others to sign up for the eBulletin online.  What is D2D? 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. See the D2D page on AFHTO’s website for more information.

  • EDAC Phone Meeting Results Report

    It is anticipated the Ontario government will introduce important developments in the evolution of primary care over the summer. In order to help prepare FHTs and NPLCs for the changes that lay ahead, AFHTO interviewed nineteen members of EDAC to obtain a better understanding of the primary care landscape and relationships that currently exist. The results from these interviews were presented to EDAC on July 28, 2015. The finding from the interviews are also outlined in a summary report.

    Resources:

     

  • Member News: Women’s health grants, IHP & Physician fellowship programs & more

    See below for more information on the following:

    • Grant and Fellowship Opportunities:
      • Research Grants for Local Women’s Health Issues – notice of intent due September 1st
      • Grants for IHPs & Physicians from the Canadian Breast Cancer Foundation (multiple deadlines)
    • Clinical Resources & Training:
      • Perinatal mental health support online (consultation, assessment & ongoing care)
      • CIHI Web Conference Series – Meeting the Needs of Health Care’s Highest Users
    • Government of Ontario:
      • Community Hub Framework Advisory Group Releases Report
      • Ontario Retirement Pension Plan Details Released

    Grant and Fellowship Opportunities:

    Grants for Local Women’s Health Issues – notice of intent due September 1st

    AFHTO members partnered with community organizations may be eligible to apply for $15,000 in one-time one year (non-renewable) grants to support research projects that advance the health of women and girls at the local level. Offered by Women’s Xchange, see below for relevant deadlines:

    • September 1, 2015 at 4:00pm – deadline for a notice of intent (necessary for application)
    • October 1, 2015 at 4:00pm – deadline to apply for funding

    To learn more including how to apply, you can visit their site.

    Canadian Breast Cancer Foundation – 2015 Call for Proposals Grant for IHPs and Physicians

    Canadian Breast Cancer Foundation (CBCF) Ontario Region has now released its Fall 2015 Call for Proposals. IHPs and physicians working with breast cancer initiatives may be eligible for the Research Grants and Fellowship Programs.

    Clinical Resources & Training:

    Perinatal mental health support available online (consultation, assessment & ongoing care)

    Mount Sinai Hospital has increased capacity to support women with perinatal mental health problems through the use of advanced video technology. They can offer consultation, assessment and ongoing patient care, either in a health care provider’s office or in the patient’s home via a new Ontario Telemedicine Network (OTN) program, Guest Link. With this program neither the patient nor health care provider needs to be a registered OTN member. Services are OHIP billable. For further information, you can visit their program website. If you have any questions, please contact Natasha Persaud, Clinical Nurse Specialist, Perinatal Mental Health at 416-586-4800 ext. 8630 or npersaud@mtsinai.on.ca.

    CIHI Web Conference Series – Meeting the Needs of Health Care’s Highest Users

    Canadian Institute for Health Information (CIHI)’s is launching a web conference series From definitions to action: meeting the needs of health care’s highest users. This series reviews examples of different approaches to defining “high users”, the contexts in which the various definitions are being used and some of the implications of using these definitions. For more program information, please visit the conferences website. If you have any questions, you can also email conferences@cihi.ca.

    Government of Ontario:

    Community Hub Framework Advisory Group Releases Report

    The Premier’s Community Hub Framework Advisory Group has now released its report, Community Hubs in Ontario: A Strategic Framework and Action Plan, outlining eight recommendations for the creation of community hubs, which have been accepted by the province. These recommendations, among others, could have implications for community coordination of patient care. To learn more or provide further input, please visit the site.

    Ontario Retirement Pension Plan Details Released

    Premier Kathleen Wynne released some key details on the province’s plan to expand pension coverage through creation of the Ontario Retirement Pension Plan (ORPP). These include timelines for implementation and eligibility including:

    • The ORPP would not apply to those currently in a comparable workplace pension plan.
    • It will be funded by equal co-contributions from both employers and employees.
    • Enrolment and contributions would be phased, with the latter reaching 1.9 per cent each from employers and employees by 2021.
    • Benefits would be earned as contributions are made and would be paid starting in 2022.

    For further details, including the definition of “comparable plan”, you can visit the site.

  • AFHTO 2015 Conference: Education opportunity for the whole team. Register now!

    The AFHTO annual conference offers unparalleled educational value. More than any other event, it is truly interprofessional, providing opportunities for everyone in primary care to learn and share innovations with their colleagues from across Ontario. This year’s sessions offer a range of topics for everyone within the primary care team, such as:

    • Planning and integrating care based on community/population needs
    • Optimizing team care for medically complex patients
    • Understanding and transforming the patient experience
    • Reducing hospital readmissions

    Don’t miss out! Register today!

    Last year attendees agreed:

    • 96.5% of respondents told us the conference “provided a valuable opportunity to share and learn about innovations, best practices and research findings to improve care and value in primary care”
    • 93.4% said that what they learned and experienced would be useful in their future practice.

    Now accredited by CFPC* and CCHL‡. Physicians can earn up to 17 Mainpro-1 credits, and CCHL members can earn up to 8 MOC-II credits.

    Members: Get even more educational value from #afhto2015 by signing up for one of our FREE pre-conference sessions!

    “Early-bird” registration ends on September 28th

    Visit our conference page to learn more about this year’s program.  We hope to see you there! *Physicians: This program has been accredited by the College of Family Physicians of Canada and the Ontario Chapter for up to 17 Mainpro-M1 credits. ‡Health Leaders: Attendance at this program entitles certified Canadian College of Health Leaders members (CHE / Fellow) to 2.5 Category II credits for Oct 27th Governance in Primary Care; 1.5 Category II credits for Oct 28th pre-conference (Leadership and IHP Sessions); 4 Category II credits for the Conference towards for their maintenance of certification requirement.

  • Forging Ahead: AFHTO members preparing for next stage of primary care evolution

    Government announcements are anticipated in early September. This email summarizes priorities for AFHTO, set through the ED Advisory Council (interview results and July 28th meeting), Physician Leadership Council (July 30th meeting) and AFHTO Board (August 12th). In light of government’s communications to date, the 5 priorities identified for AFHTO were:

    1. Developing and strengthening relationships with (and education for) LHINs, in anticipation of a tighter relationship between LHINs and primary care.
    2. Addressing the province’s intent to broaden access to teams while ensuring teams can continue to deliver quality care.
    3. Determining how to measure “Capacity” – a fundamental component in assuring quality care.
    4. Shaping what it means to take a “Population-Based Approach to Primary Care”.
    5. Strengthening governance of teams – a critical requirement for leading this next stage in primary care’s evolution.

    Scroll down to read more about these priorities.

    Stay Tuned:

    • Sept. 17 — The ED Advisory and Physician Leadership Councils will meet together to review further developments from government and plan next steps.
    • Oct. 28 — Leadership session at the AFHTO conference is open to leaders of all member organizations.
    • November through February — AFHTO is organizing “Regional Leadership Sessions” – to include AFHTO leadership, FHT/NPLC EDs, Lead Physicians, Board Chairs, LHIN leadership, and other stakeholders deemed appropriate within each LHIN region.

    What can you do now? Relationships are fundamental…start getting to know the FHTs/NPLCs in your region, think about how you could strengthen partnerships with the LHIN or how AFHTO might assist! Moving Forward – AFHTO will continue to engage our membership and keep everyone informed as soon as formal announcements are made or direction is received.  Working together we will identify and provide the necessary education, training and guidance needed to lead the way for comprehensive, high-quality, team-based primary care.

    1.    Relationship with/Education for LHINs

    All members – EDAC, PLC and the AFHTO board – as a priority to be addressed immediately, to prepare for the evolution ahead. Next Steps:

    • To build profile for FHTs and NPLCs with each LHIN CEO, ED Advisory Council reps have been invited to join with AFHTO’s ED (and one or two other EDs/Lead MDs) in meeting with their respective LHIN CEOs.
    • To foster greater understanding about primary care across LHIN staff, AFHTO has initiated development of educational material together with the LHIN Collaborative.
    • These two activities will help set the stage for Regional Leadership Sessions in each LHIN (November through February).

    2.   Broadening Access to Teams

    The Ministry has been clear on a shift toward improving “Access to team-based primary care for all Ontarians who would most benefit” – currently only a quarter of the population is served by FHTs/NPLCs and have access to IHPs within team based care. HOW this is done, lends itself to a number of challenges and potential opportunities. How primary care is organized going forward, the possible role of the LHIN, and expectations of FHTs/NPLCs will be key factors in determining how we can broaden access to team based care. Next Steps:

    • AFHTO’s paper on optimizing value of and access to team-based primary care presents evidence-informed advice on how to spread access to high-quality team-based primary care in a way that achieves the best value, and provides a number of recommendations to the Ministry.
    • The joint EDAC/PLC in-person meeting on September 17th will identify areas for further recommendations for the Ministry and members on approaches to broadening access to teams (including addressing challenges such as liability).

    3.   Advancing Capacity Measurement

    Team capacity has been the core issue for FHTs and NPLCs seeking Ministry funding to meet patient needs. As the province calls for broader access to teams, this will be THE number one issue – what can teams take on while assuring quality of care? Quality, capacity and total cost of care are the core concepts for measurement in the “Starfield Principles”, adopted by AFHTO. Through D2D 2.0, we have progressed in measuring cost and quality. AFHTO members, staff and other stakeholders are working to find meaningful ways to measure capacity. Expanding access to teams only makes sense where capacity is sufficiently developed. Next Steps:

    • In-depth clinical consultations are underway on capacity measurement (and other strategic indicators). Click here to participate.
    • Aiming to include a capacity measure in D2D 3.0 (launching January 2016).

    4.   Population-based Approach to Primary Care

    MOHLTC leaders have consistently used the term “population-based primary health services for Ontarians”. Working collaboratively to plan and offer programs and services that are designed to meet the specific needs of the patient population will be central to implementing a population based approach. Next Steps

    • AFHTO will continue to work with the Ministry and other stakeholders to establish a clear definition and principles of a population-based approach to primary care.
    • AFHTO is establishing a joint Work Group with MOHLTC PHC Branch to improve the approach to program planning and the ministry’s template for reporting on program plans (Schedule A in FHT contracts/Schedule E in NPLC contracts). A workshop will be provided at the AFHTO 2015 conference with a focus on: what constitutes a program; key elements of a well-designed population-based approach to program planning; how to conduct a needs assessment; goal setting; performance measurement principles and evaluation; and how to use the reporting tool effectively.
    • Members are encouraged to start looking at their own communities, to get to know the teams in the same geographic region, and to begin to explore ways that teams can reach out to larger segments of the population that are not formally rostered patients.

    5.    Governance of Teams

    Given the Ministry’s anticipated announcement, strong governance and leadership practices will be even more paramount for FHTs/NPLCs to successfully navigate the upcoming transition and change. Next Steps:

    • AFHTO is offering the Effective Governance for Quality in Primary Care workshop to AFHTO member board members, executive directors and lead clinicians on October 27th (one day prior to the AFHTO conference).
    • AFHTO will work with the Ministry to target FHTs/NPLCs who may benefit from individualized plans to develop effective governance practices and leadership capabilities.
    • Through the work of D2D, AFHTO will begin looking at the correlation between high performing teams and associated governance structures.

    AFHTO is supporting the development of an ‘ED Mentorship Program’ as a way to provide support and encourage knowledge translation for new EDs and EDs requiring additional guidance.

  • AFHTO Bright Lights Awards – thank you to all who submitted nominations

    Thank you to all who submitted nominations to highlight significant achievements being made in primary care. The hard work and thoughtful innovations of our members are truly inspiring. Next steps for awards selection:

    • All nominees received a confirmation e-mail on August 11. This e-mail is your assurance that the nomination was received and will be reviewed.
    • If you didn’t receive the confirmation e-mail, please e-mail conference@afhto.ca to confirm the status of your submission. Please identify the title, name and other nominee details.
    • All nominations received are now being sent to the Bright Lights Review Committee.
    • All award winners will be announced at the Bright Lights Awards Dinner on October 28.

    Thanks once again to all of you for your daily contributions to strengthening primary care. We look forward to celebrating all the winners and nominees at the Bright Lights Awards Dinner on October 28.

  • Last Chance! Bright Lights Nominations due by noon tomorrow

    Don’t forget to send in your nominations and supporting documents for the 2015 Bright Lights Awards. The deadline is 12:00 pm tomorrow (Tuesday, August 11). We look forward to hearing your stories!

    Experiencing issues submitting your nomination form? Due to the high volume of responses coming in today there may be delays submitting your Bright Lights nomination. If the nomination doesn’t go through on the first try, please try again a little later. As a backup to your submission, send a Word version of your nomination with your supporting materials to info@afhto.ca before noon tomorrow. If you have any questions or concerns please contact us, we’ll be happy to assist.