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Health Quality Ontario: Health System Performance New Zealand Master Class March 25, 2014 . Monitoring & Reporting on the Quality of Ontario's Health Care System.
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Health Quality Ontario:Health System Performance New Zealand Master Class March 25, 2014
Monitoring & Reporting on the Quality of Ontario's Health Care System • Ontarians want a sustainable public health care system that helps people stay healthy and delivers excellent quality care when they need it • Monitoring and public reporting on quality helps define excellence and provides a clear standard with which to articulate what high-quality care is and what success looks like • HQO supports transparency and accountability through objective monitoring and reporting on health system performance www.HQOntario.ca
Excellent Care for All: HQO’s Mandate • Within the domain of monitoring and reporting, the Excellent Care for All Act, 2010, identifies four areas of focus: • Access to publicly funded health services • Health human resources in publicly funded health services • Consumer and population health status • Health system outcomes www.HQOntario.ca
Presentation Overview • HQO’s suite of performance monitoring and reporting tools • Stakeholder engagement in HQO’s development and reporting activities • Questions and discussion www.HQOntario.ca
Performance Monitoring and Reporting • Public Facing Reporting • Common Quality Agenda/ Yearly Report • Online reporting • Theme reports (Planned) • Confidential Tools and Reports • Primary Care Practice Report • Quality improvement monitoring • Indicator Development • Primary Care Performance Measurement Framework • Patient Experience • Aggregate-level data only www.HQOntario.ca
Public Facing: Common Quality Agenda Asystem-wide initiative informed by three goals: • Focus the health care system on a small number of priority areas for quality improvement • Leverage performance reporting as a mechanism for improvement • Improve quality through partnership • Linked to HQO’s quality improvement and evidence functions • Provincial- regional- and over time, facility-level, named reporting • Trending data (10 year historical, as available) • Development of indicator benchmarks (as appropriate) www.HQOntario.ca
Common Quality Agenda www.HQOntario.ca
Public Facing: Online Reporting Web-based reporting for three sectors: • Home care: 11 indicators • Provincial- regional- and service provider-levels (named) (personal care worker, home care nurses) • Data refreshed annually • Hospital care (currently Patient Safety): nine indicators • Provincial- facility-levels (named) • Data refreshed monthly, quarterly, annually • Long-term care: 12 indicators • Provincial- regional- and facility-levels • Data refreshed annually • Facility-level searches by topic, facility name, or location www.HQOntario.ca
Long-Term Care Public Reporting www.HQOntario.ca
Long-Term Care Public Reporting www.HQOntario.ca
Public Facing: Theme Reports New for 2014 and ongoing: • Multiple reports per year focusing on key issues related to the health care system • Topic selection and report development in partnership with provincial health organizations. For example: • Cardiac Care Network • Public Health Ontario • Community Care Access Centres • Descriptive and in-depth, theme reports may also be positioned as “quick response” reports, responding to critical emerging issues www.HQOntario.ca
Confidential Tools and Reports HQO provides customized tools and reports to health system providers: • Primary Care Practice Report • Administrative data including: • Practice demographics (e.g., age, gender, rurality, case mix) • Health service use (e.g., Emergency Department visits, admissions, specialist visits), and • Chronic disease prevention and management (e.g., diabetes management, cancer) • Practice, group, region, and province performance comparisons • Quality improvement initiative monitoring tool • Standardized and custom quality improvement indicators • Free web-based platform for run charts, control charts, tables www.HQOntario.ca
Confidential Tools and Reports: Quality Improvement Reporting & Analysis Platform (QI RAP) www.HQOntario.ca
Indicator Development: Primary Care Performance Measurement • Partnership model todevelop a comprehensive primary care performance measurement framework • Designed to meet the information needs of patients, the public, health providers and policymakers • Developed to address system- and practice-level data requirements: • System-level: Drive short-term improvement, support longer term goals and track the impact of policy changes and investments • Practice-level: Inform planning, performance monitoring and quality improvement www.HQOntario.ca
The Primary Care Performance Measurement Framework * * * * * * * * * * * * * * * www.HQOntario.ca
EHR/EMR data Agreement on performance measures Driving improvement 1. Better care 2. Better health 3. Better value Survey data Administrative data Moving Forward www.HQOntario.ca
Indicator Development: Patient Experience To identify/develop a practice-level patient experience survey and implementation guide: • Suitable for use with different models of primary care • To support/inform quality improvement at the practice-level • Leverages/aligns with subsets of items from existing instruments • Based on a rigorous development methodology • Stakeholders and partners engagement throughout the development and testing process • Aligned HQO – Primary Care Association strategy for communication and dissemination of materials www.HQOntario.ca
Indicator Development: Patient Experience Phase 1: Survey &implementation strategy development • Advisory Committee with broad practice model, association, ministry psychometric and patient advocacy group representation • Collection, review and crosswalk of existing instruments, domains and survey items • Key stakeholder interviews • Cognitive and psychometric survey testing Phase 2: Implementation testing and refinement • Expanded survey and implementation testing • Revisions and dissemination www.HQOntario.ca
External Stakeholder Engagement • Health System Performance Strategic Plan • Stakeholder feedback on the overarching direction of HQO’s performance monitoring and reporting strategy • Provincial Measurement and Reporting Committee • Service provider, association, patient, academic, ministry and data providers contribute to the identification of measurement priorities, alignment opportunities and measurement advocacy • Sector-specific Advisory Committees • Sector specific committees for discussion of measurement alignment, capacity building, strategies and issues • Technical Working Groups • Indicator and data expertise to guide indicator technical specifications, benchmark and target development, measurement and data advocacy
Thank you • and • conversation