Ultimate Blogging Championship

Category: Uncategorized

  • 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!

  • External evaluation report on family health teams is now available

    The Ministry of Health and Long-Term Care has released the report: An External Evaluation of the Family Health Teams (FHT) Initiative. It is a longitudinal study over the period from Dec. 2008 to November 2013, prepared by the Conference Board of Canada under contract to the ministry. AFHTO has prepared a summary of this 311-page report. The FHT evaluation report shows clear evidence of improvement over the study period, 2009-2012:

    • Patient survey data suggests the ability to get same-day appointments in FHTs ranks among the best in the world for primary care. 79% of patients reported they could get a same day appointment. This compares to 40% for Ontario (and 72% for top-performing Germany) in Health Quality Ontario’s Measuring Up report
    • FHTs are offering a wider range of programs and services to promote health and manage chronic disease. Interprofessional teams make it possible to bring together the variety of skills needed to help people stay as healthy as possible

    AFHTO welcomes this release. The FHT evaluation report provides further evidence and direction for the Ministry, AFHTO, FHTs and other primary care organizations together with their associations, on what is needed to continue to improve. We have better understanding of factors that have improved patient experience in accessing care, including strong leadership, team culture, use of patient data, and provider involvement in quality improvement activities. The most notable findings indicate that staff make the biggest difference to patient experience; however recruitment and retention of staff is particularly challenging. The FHT evaluation report’s findings reinforce those of previous AFHTO reports – below-market compensation is a problem; adequate funding is needed to solve it. Improvement continues. Since August 2013, this has been greatly assisted through government funding for Quality Improvement Decision Support (QIDS) Specialists and AFHTO’s provincial QIDS and Governance + Leadership programs. The AFHTO membership is advancing to achieve optimal quality, access and total cost of care, in line with public and patient expectations. Click below to link to further information:

  • 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.

  • 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.

    1. 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.
    2. 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.
    3. 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?

    1. 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.
    2. 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.
    3. 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.
    4. 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.

  • 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.

  • 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.

     

  • HQO Releases Report On End-of-Life Care in Ontario

    Dec. 15 – Health Quality Ontario’s (HQO) End-of-Life Health Care in Ontario report was released today. Click here to download the full report and recommendations. The report addresses where the health system must improve to ensure the best end-of-life care for all Ontarians, and highlights the need for an increased number of professionals trained in palliative care. The report also identifies the need for a more patient-engaged approach to end-of-life care, encouraging productive, informed conversations about end-of-life care between patients, their loved ones and their care providers. The End-of-Life Health Care in Ontario report is accompanied by recommendations from HQO’s Ontario Health Technology Advisory Committee (OHTAC) and builds on important work by Cancer Care Ontario, the Local Health Integration Networks, the Registered Nurses’ Association of Ontario, and the Ontario Medical Association, among others. For more information:

  • EDAC News: Ensuring Value, FHT Evaluation, & Work Ahead

    AFHTO’s Executive Director Advisory Council (EDAC) met yesterday. This update provides an overview and highlights key items discussed:

    • Ensuring EDAC Value
    • FHT Evaluation Report
    • Towards the Next Ministry Contract
    • PHC Branch Meeting
    • QIDS Program Update

    Ensuring EDAC Value

    EDAC plays a significant role in enabling EDs to surface operational issues, provide a sounding board on operational matters and give advice to AFHTO staff as needed. EDAC provides a platform for our members to work together to advance best practice knowledge transfer, enhance collaborations and foster leadership communications. In order to continue with the effectiveness of EDAC, the Terms of Reference have been updated and a clear work plan and set of objectives has been developed to guide the course of work over the next 6 months. EDAC members recognize the need to support their ED colleagues. An initial priority is to develop an ED Resource Toolkit consisting of standardized resources and best practice templates pertaining to governance and operations. EDAC members also shared how they communicate, engage and consult with the group of EDs they represent within their group (i.e. LHIN region or by special focus – aboriginal/inuit, academic, blended salary model or NPLC) and keep them informed of EDAC’s work as it progresses. Click here for a list of all EDAC members.

    FHT Evaluation Report

    In 2008 the MOHLTC commissioned an external five-year evaluation of the FHT model of primary care. An embargoed copy of the final evaluation report, led by the Conference Board of Canada has been shared with AFHTO, FHTs and NPLCs. A membership webinar was held on December 10th to review the results and AFHTO has developed a summary to aid in the assessment and interpretation of the document.  It is anticipated that MOHLTC will release the report in the next few weeks. The report points to areas of focus for optimizing FHT/NPLC value, function and operations. EDAC’s work plan is aimed at some of the key points in the report – enhancing leadership capacity, strengthening governance and fostering collaborative working relationships as crucial components for achieving high-performing primary healthcare teams.

    Towards the Next Ministry Contract

    MOHLTC-FHT contracts expire on Mar.31, 2016. The templates that are developed to replace them could significantly reshape the relationship FHTs have with the Ministry. For this reason, under the direction of the board, AFHTO is moving along the journey to work with and on behalf of members to achieve a contractual relationship that is much more conducive to achieving the vision that all Ontarians will have timely access to high-quality comprehensive primary care that is delivered by the right mix of professionals, informed by the social determinants of health, anchored in an integrated and equitable system, and sustainable.

    • Performance Measurement & Accountability

    A central component for new contract development is the process to determine the performance measures to be reported under Schedule A. The ministry is looking to our members, in collaboration with other relevant stakeholders, to recommend performance measures aligned with the ministry’s focus on enhancing access/integration and supporting quality and sustainability in primary care. We are well-positioned to do this, by leveraging our collective work on the next iteration of Data to Decisions (D2D 2.0) and continuing to engage our members and other stakeholders (ICES, HQO, AOHC, OMA).  Encourage your team members to participate in the D2D 2.0 indicator selection process – details to be emailed on Dec. 15.

    • MOHTLC-FHT  Contract Template

    The contract template itself identifies the terms and conditions of funding in addition to some programmatic elements. Reviewing current MOHLTC-FHT contract templates provides the opportunity to develop more mature and meaningful contracts that will support interprofessional teams to continue to deliver high-quality primary care and improve the health of the people in the communities served. A number of EDAC members volunteered to participate on a working group that will provide recommendations on possible amendments to the contract template that will support FHTs in achieving their objectives.  All members will be kept informed and engaged as this process unfolds.

    Meetings with the Ministry’s PHC Branch

    The most recent quarterly meeting between AFHTO and the Primary Health Care (PHC) Branch was held on November 21st and an email update was circulated to members on November 24th. Following from this, EDAC members discussed:

    • 2015/16 Operating Plan & Funding Envelope

    The PHC branch has requested input from EDAC on the process, timelines and draft materials. Over the next week all members of EDAC will review the draft documents and compose feedback. A number of EDAC volunteers will synthesize the feedback received and provide a report back to the Ministry.

    • 2013/14 Annual Report Feedback

    It was noted that over half of the EDAC members polled have received an annual report feedback from their Ministry consultants. While overall there is consensus that these scorecards are valuable, it is recognized that many of them contain transcription and statistical errors. Members are encouraged to provide feedback to their Ministry consultants to rectify errors accordingly. EDAC will develop a summary of recommendations and advice to the PHC branch to support the development of more accurate and useful feedback.

    • Physiotherapy Allocation Updates

    All physiotherapy allocation letters have been circulated. The PHC Branch acknowledged that while the application was open to about 300 interprofessional teams (FHTs, NPLCs, CHCs, AHACs) there was only limited funding available. For those members who wish to discuss their application, they can contact Sue Hache (Senior Program Consultant, Interprofessional Programs Unit MOHLTC) at 613-536-3206.

    • Recruitment & Retention

    This continues to be the area of primary focus for AFHTO. EDAC members received an update on advocacy activity. Again members are encouraged to meet with MPPs so that political pressure will continue to keep this issue on the front burner.  (And thank you to EDs and others who have been active. The Minister has faced a number of questions in the legislature.)

    • Need for timely, robust and helpful feedback from Ministry

    Drawing some threads through these discussion items, EDAC members observed the need to work in a more meaningful and mature partnership with the Ministry. Feedback is critical to improving the delivery of care. In order to be useful, the feedback must be timely, with sufficient context and specificity to understand and act on it, and be constructive, so it can lead to solving problems and improving performance. AFHTO will be taking this message forward to PHC Branch to work together to improve.

    QIDS Program Update

    A brief update was provided on the status and current work of the QIDS program. Key highlights are identified below:

    • Build capacity to measure and improve interprofessional primary care by applying the lessons learned from D2D 1.0 to the next iteration (ie 2.0) tentatively scheduled for mid-May 2015.
      • Reminder that indicator survey will go out Dec.15, for reply by late January.
      • Advocate for manageable meaningful measurement and accountability in the upcoming renewal of the FHT contract with MOHLTC
      • An evaluation of the QIDS program will be conducted and will include direct input from QIDSS and host and partner EDs. Surveys will be circulated over the next few weeks.

    The next meeting of EDAC will be held in late January/early February. For any further questions, please contact your EDAC representative (click here for list) or:

    Kavita Mehta (Chair, EDAC) Executive Director, SETFHT kavita.mehta@setfht.on.ca Bryn Hamilton Provincial Lead, Governance & Leadership Program 647-234-8601 Bryn.Hamilton@afhto.ca

     

  • Chief Medical Officer of Health Memo: new and updated on Ebola virus disease resources

    The Chief Medical Officer of Health has released the following new and updated resources on Ebola virus disease for primary care and paramedic services:

    • updated Chief Medical Officer of Health Directive for Paramedic Services
    • summary of changes to the Chief Medical Officer of Health Directive for Paramedic Services
    • new Chief Medical Officer of Health Directive for Primary Care Settings
    • screening tools for paramedic services and primary care settings

    These resources are now posted in English at www.ontario.ca/ebola and in French at www.ontario.ca/virusebola.

  • Data to Decisions: Alignment with other initiatives

    STARFIELD FRAMEWORK DEVELOPMENT PROJECT   AFHTO’s approach to primary care measurement is based on the Starfield principles.  These principles include a focus on the relationship with patients and ability to deliver the comprehensive care patients value.  (see The Starfield model: Measuring comprehensive primary care for system benefit).  AFHTO has invested recently in an effort to “get started” with membership-wide performance measurement in the form of Data to Decisions 1.0: Advancing Primary care.  The next steps for D2D 1.0 are intended to advance meaningful measurement in primary care in a way that is consistent with Starfield principles.   The scope of the Starfield framework development project includes a series of activities by AFHTO members and external partners, ranging from confirmation of the theoretical basis to establishing weights for the components of the measures of doctor-patient relationship to developing technical solutions for reporting, analyzing and disseminating data and evaluating the impact on quality of care. Project Coordinator Role Reporting to the Provincial Lead for the QIDS program, the Project Coordinator will play a critical role in delivering on this objective. The role will be responsible for coordinating and aligning the efforts of external partners with AFHTO’s members in a way that leverages the ongoing work of the QIDS program.     The specific role of the position includes the following:

    • Manage work plan: Under the direction of the Provincial Lead for the QIDS program, the project coordinator will collaboratively develop and implement a detailed work plan focused on incorporating Starfield principles into AFHTO’s ongoing efforts to advance manageable meaningful measurement, based on an existing high-level summary of proposed work streams.
    • Recruit partners and participants:
      • Facilitate the development and application of criteria by which projects proposed by external partners will be judged for inclusion in the overall work plan, based on each project’s capacity to achieve the goals of the defined work streams.
      • Recruit patients, research partners and AFHTO members for relevant roles in the project
      • Contribute to positive relationships and effective communications with other QIDS program partners including other primary care providers, research partners, the Ministry, LHINs  and related agencies (e.g. HQO, eHealth Ontario, OntarioMD, CIHI) and EMR vendors, among others
    • Facilitate access to external funding opportunities: Identify and facilitate applications for opportunities for funding for research program, including tracking revenue and spending
    • Communicate:
      • Develop and implement communication processes to increase awareness and support of Starfield principles and their importance in demonstrating the value of interprofessional comprehensive, patient-centered primary care
      • Provide secretariat support to the Research Advisory Team (Starfield), including providing ongoing progress reports to AFHTO membership and external partners
      • Contribute to a culture of learning and continuous improvement in performance measurement within AFHTO member organizations.

    High-level work plan

    1. Validate theoretical constructs of the Composite Indicator of quality (a fundamental component of the approach), including examination of compliance with best practice in constructing composite indicators.
    2. Recruit primary care teams to participate in an expanded pilot of measurement consistent with Starfield principles.
    3. Establish a sustainable process for generating “patient expectations”, to be used as weights in the composite indicator
    4. Establish a sustainable process for generating “threshold” levels for performance on the components of the composite indicator
    5. Establish a sustainable process for data capture from patient surveys (ie patient experience input), administrative data sources and, where necessary, EMRs.
    6. Establish a sustainable process for data submission, data management and analysis to generate the scores for composite indicator, capacity and cost.
    7. Establish a sustainable process aligned with best practices for providing feedback that leads to action on primary care outcomes.
    8. Evaluate impact of the reporting/feedback process on primary care outcomes in the candidate teams and measurement culture in primary care.