Category: Uncategorized

  • Data to Decisions: Advancing Primary Care

    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. QIDS Specialist Host & Partnership Forum: The September 1st, 2015 forum was attended by over 90 QIDS specialists and QIDS specialist host and partner Executive Directors.  The purpose was to celebrate our collective progress via analysis of D2D 1.0 vs. 2.0 data and preparing teams to move forward faster further. For more information check out the presentation slides or watch a recording of the webinar. Why participate in D2D? Click here for a video to help EDs, physicians, Boards and QIDSS start discussing D2D and how your team can participate. 

    Past Reports

    The submission/historical data forms for D2D 1.0 and D2D 2.0 are temporarily unavailable while we prepare for the launch of D2D 3.0 on December 3, 2015.

    The D2D journey continues – getting started on the next iteration of D2D

    Measures will continue to be refined to become more and more meaningful to providers and their patients, and acted upon to improve care. Calling all clinicians! Make sure D2D makes good clinical sensejoin the conversations by July 24, 2015 to come up with better indicators for Emergency visits, 7-day follow up and other clinical measures.

    Stay up to date on D2D – The eBulletin is released bi-weekly to help members keep track of upcoming D2D deadlines and share updates and information about manageable meaningful measurement.

    Resources and Links

    For more information about D2D contact Carol Mulder, QIDS Provincial Lead, carol.mulder@afhto.ca.

  • Data to Decisions 2.0 is here! Join the orientation webinars today at 12:00 PM or 4:30 PM

    D2D 2.0 - colour logo for website

    Data to Decisions (D2D) 2.0 is here!

    D2D is a ground-breaking report on performance in team-based primary care in Ontario.

    • AFHTO members are leading the way to advance manageable and meaningful measurement across primary care.
    • This work is critical. Robust measurement is a mandatory ingredient for strengthening comprehensive primary care as the foundation.
    • AFHTO members are keen to step up to show the value that primary care teams deliver to patients, communities and the health system.
    • Teams can compare their results to their peers, however individual team results remain confidential to that team.

    D2D 2.0 demonstrates significant progress in this journey:

    • More than 100 family health teams and nurse practitioner-led clinics have voluntarily submitted their data.
    • This gives insight into the care of over 1.7 million Ontarians.
    • Comparative analyses indicate the results are representative of the full AFHTO membership of Family Health Teams (FHTs) and Nurse Practitioner-Led Clinics (NPLCs).

    The D2D journey is revealing how to get better at measuring what matters most:

    • AFHTO members are shaping implementation of Health Quality Ontario’s Primary Care Performance Measurement Framework (PCPMF) – in identifying priority measures for system and practice level and in refining these measures.
    • Working with the Institute for Clinical Evaluative Sciences (ICES), AFHTO members are leading the way to measure the average cost of all health care received by the panel of patients served by each team, adjusted for the characteristics of that patient panel.  This measure is highly important since it:
      • Can be calculated for the panel of patients in any type of primary care practice in the province.
      • Enables cost to be monitored over time to better understand the impact of improvements in quality of primary care and the health of patients on the sustainability of health care system.
    • To better reflect the many facets of comprehensive primary care that matter to both patients and providers, AFHTO members have completed their first iteration of a composite measure of quality.
    • Working across such a large number of primary care teams is enabling innovation to simplify data extraction from EMRs and improvement in data quality.

    D2D 2.0 shows encouraging results for AFHTO members and provides guidance for further improvement (click here for table):

    • Overall, AFHTO members are performing better than the provincial average on same day/next day access (40% better), cancer screening (10% better), and patient satisfaction with their involvement in decision-making (4% better).
    • There are preliminary indications that patient satisfaction with the courtesy of office staff has improved over the past 3 years (20% improvement).
    • Most teams rank high on some indicators and lower on others. D2D enables teams to compare themselves to their peers and pinpoint their improvement activity.

    The D2D journey continues. Measures will continue to be refined to become more and more meaningful to providers and their patients, and acted upon to improve care.

    Thank you to all AFHTO members who participated in D2D 2.0.  We hope you will all consider participating in the next iteration, to be reported in January 2016.

  • Data to Decisions 2.0 is here! Join the orientation webinars today at 12:00 PM or 4:30 PM

    D2D 2.0 - colour logo for website

    Data to Decisions (D2D) 2.0 is here!

    D2D is a ground-breaking report on performance in team-based primary care in Ontario.

    • AFHTO members are leading the way to advance manageable and meaningful measurement across primary care.
    • This work is critical. Robust measurement is a mandatory ingredient for strengthening comprehensive primary care as the foundation.
    • AFHTO members are keen to step up to show the value that primary care teams deliver to patients, communities and the health system.
    • Teams can compare their results to their peers, however individual team results remain confidential to that team.

    D2D 2.0 demonstrates significant progress in this journey:

    • More than 100 family health teams and nurse practitioner-led clinics have voluntarily submitted their data.
    • This gives insight into the care of over 1.7 million Ontarians.
    • Comparative analyses indicate the results are representative of the full AFHTO membership of Family Health Teams (FHTs) and Nurse Practitioner-Led Clinics (NPLCs).

    The D2D journey is revealing how to get better at measuring what matters most:

    • AFHTO members are shaping implementation of Health Quality Ontario’s Primary Care Performance Measurement Framework (PCPMF) – in identifying priority measures for system and practice level and in refining these measures.
    • Working with the Institute for Clinical Evaluative Sciences (ICES), AFHTO members are leading the way to measure the average cost of all health care received by the panel of patients served by each team, adjusted for the characteristics of that patient panel.  This measure is highly important since it:
      • Can be calculated for the panel of patients in any type of primary care practice in the province.
      • Enables cost to be monitored over time to better understand the impact of improvements in quality of primary care and the health of patients on the sustainability of health care system.
    • To better reflect the many facets of comprehensive primary care that matter to both patients and providers, AFHTO members have completed their first iteration of a composite measure of quality.
    • Working across such a large number of primary care teams is enabling innovation to simplify data extraction from EMRs and improvement in data quality.

    D2D 2.0 shows encouraging results for AFHTO members and provides guidance for further improvement (click here for table):

    • Overall, AFHTO members are performing better than the provincial average on same day/next day access (40% better), cancer screening (10% better), and patient satisfaction with their involvement in decision-making (4% better).
    • There are preliminary indications that patient satisfaction with the courtesy of office staff has improved over the past 3 years (20% improvement).
    • Most teams rank high on some indicators and lower on others. D2D enables teams to compare themselves to their peers and pinpoint their improvement activity.

    The D2D journey continues. Measures will continue to be refined to become more and more meaningful to providers and their patients, and acted upon to improve care. Thank you to all AFHTO members who participated in D2D 2.0.  We hope you will all consider participating in the next iteration, to be reported in January 2016.

  • D2D 2.0 Orientation and Supporting Materials

    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:

    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.

  • Regular primary care provider – individual – Potential actions related to processes of care

    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.
  • Regular primary care provider – individual – Interpretive notes

    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.