1. Health Quality Ontario: Health System Performance New Zealand Master Class March 25, 2014

2. 1 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

3. 2 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: 1.Access to publicly funded health services 2.Health human resources in publicly funded health services 3.Consumer and population health status 4.Health system outcomes www.HQOntario.ca

4. 3 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

5. 4 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

6. 5 Public Facing: Common Quality Agenda A system-wide initiative informed by three goals: 1.Focus the health care system on a small number of priority areas for quality improvement 2.Leverage performance reporting as a mechanism for improvement 3.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

7. 6 Common Quality Agenda

8. 7 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

9. 8 Long-Term Care Public Reporting www.HQOntario.ca

10. 9 Long-Term Care Public Reporting www.HQOntario.ca

11. 10 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

12. 11 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

13. 12 Confidential Tools and Reports: Quality Improvement Reporting & Analysis Platform (QI RAP) www.HQOntario.ca

14. 13 Indicator Development: Primary Care Performance Measurement Partnership model to develop 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

15. 14 The Primary Care Performance Measurement Framework www.HQOntario.ca * * * * * * * * * * * * * * *

16. Moving Forward 15 Agreement on performance measures EHR/EMR data Driving improvement 1. Better care 2. Better health 3. Better value Survey data Administrative data www.HQOntario.ca

17. 16 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

18. 17 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

19. 18 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 18

20. Thank you and conversation