Primary Health Care System Level Indicators Presentation March - PowerPoint PPT Presentation

Primary Health Care System Level Indicators Presentation March 2015 1

Presentation Outline • Background – Alberta's Primary Health Care Strategy – Evaluation Framework and Logic Model – Measurement and Evaluation Working Group • Progress to Date • PHC System Level Indicators • Challenges • Timing • Supports Confidential – Content not for distribution. 2

Faculty/Presenter Disclosure • Faculty − Allison Larsen • Relationships with commercial interests − No relationships with commercial interests Confidential – Content not for distribution. 3

Disclosure of Commercial Support − This program has received no financial support or in- kind funding from commercial organizations Potential for conflict(s) of interest: – None Mitigating Potential Bias: − As the program received no commercial support or in- kind funding, there are no sources of bias to mitigate − Sessions were planned based on input from a planning committee that included physicians Confidential – Content not for distribution. 4

Background Alberta’s Primary Health Care Strategy • Released in May 2013, Alberta’s Primary Health Contributors:  Physicians  Care Strategy sets the direction for the long-term Interdisciplinary  National  primary health care (PHC) transformation and Provincial  Operations reinforces the vision for “a PHC system that supports Albertans to be as healthy as they can be”. • The Strategy was informed by an Advisory Committee with representatives from AH, AMA, AHS, Professional Colleges & Associations, academics and the primary care alliance. Confidential – Content not for distribution. 5

Background Alberta’s Primary Health Care Strategy • The Strategy involves 14 goals based on three strategic directions: enhancing the delivery of care, bringing about cultural change and establishing building blocks for change. • Three strategic directions will result in six key outcomes: – Attachment – all Albertans have a health home and are attached to a physician; – Access – Albertans have timely access to a primary health care team; – Quality – clinical and social supports come together to promote wellness – Self Management – Albertans are involved in their care – Improvements in Health Status and Care Experience – Albertans have better health overall and report positive experiences – Provider Engagement and Satisfaction – providers are satisfied and happy with their work lives and able to provide quality care. Confidential – Content not for distribution. 6

Background PHC Evaluation Framework • The PHC Evaluation Framework will guide evaluation activities and performance reporting of Alberta’s PHC system and address concerns put forth by Alberta’s Office of the Auditor General in their 2012 Report. • The Framework includes goals from the PHC Strategy that highlight the Department’s approach to performance measurement . • The Measurement and Evaluation Working Group (MEWG) was established to support the implementation of the Primary Health Care Evaluation Framework by providing recommendations and advice relating to performance measurement and evaluation activities that focus on improving quality and outcomes. Confidential – Content not for distribution. 7

Background: PHC Evaluation Framework Logic Model Confidential – Content not for distribution. 8

Background : System Level Indicators • There is a need for standardized indicators to measure the impact of ongoing innovation on patient and population health outcomes.. • These System level indicators will inform Albertans of the progress being made in primary health care. • The indicators flow from the Primary Health Care Evaluation Frameworkalign and align with the outcomes listed in the Primary Health Care Strategy. • Selected indicators are useful in quality improvement initiatives at the PCN and provider level. • PHC System Level Indicators were confirmed by the MEWG in September 2014. Confidential – Content not for distribution. 9

Progress to Date • Eight indicators included in the requirements of PCN funding agreements in October 2014. • Guideline prepared to explain the indicators and provide a summary of expectations. • Focus groups held for further input on acceptability, clarity of instructions and implementation challenges. • Measurement and Evaluation Working Group to work toward an implementation package for each indicator. Confidential – Content not for distribution. 10

PHC System Level Indicators • The indicators furthest along in readiness for implementation: 1. Time to third next available appointment with a provider for the fiscal year 2. Percent of recommended screens that the clinic has offered to paneled patients 3. Percentage of patients answering satisfied or very satisfied to the question – Overall, how satisfied are you with the care you get from the clinic? Confidential – Content not for distribution. 11

PHC System Level Indicators Continued . . . 4. Percent of patients who are returning to the same provider at the clinic for a subsequent visit 5. The percentage of identified team members responding to a team effectiveness survey 6. Percent of paneled patients with a chronic disease who were offered self-management supports during the fiscal year 7. Percent of paneled patients with a chronic disease who report maintaining or improving quality of life as measured by the EQ-5D tool during the fiscal year Confidential – Content not for distribution. 12

1. Time to third next available appointment with a provider for the fiscal year Rationale  A measure of access to primary health care services.  The most common measure of access in Alberta.  Can be used, along with related information, to identify system constraints such as:  availability of providers;  information on where patients ultimately go for services when there is limited access; and  need for workflow improvements in a PCN. Confidential – Content not for distribution. 13

1. Time to third next available continued… Calculation The number of providers:  Reporting an average of 0 to .99 (same day access) ____________  Reporting an average of 1.00 to 4.99 ____________  Reporting an average of 5.00 to 8 .99 ____________  Reporting an average of 9.00 to 21.99 ____________  Reporting an average of 22+ ____________  Total number of providers reporting ____________ Confidential – Content not for distribution. 14

2. Percent of recommended screens that the clinic has offered to paneled patients Rationale  Appropriate screening identifies health risks earlier so that action can be taken to improve health outcomes.  Measurement encourages standardized screening across the province.  ASaP has determined which screens are appropriate based on evidence.  Tracking screening compliance provides information that can be analysed along with related information to identify:  the long-term impact on health outcomes  need for workflow improvements in a PCN Confidential – Content not for distribution. 15

2. Percent of recommended screens continued… Calculation (for each maneuver)  Numerator – total number of paneled patients meeting the screening criteria that were offered a screen (inferred screen may be counted where offers are not documented)  Denominator – total number of paneled patients meeting the screening criteria Other considerations  The guideline proposes that providers can select the maneuvers to be measured (minimum of four). Confidential – Content not for distribution. 16

3. Percentage of patients answering satisfied or very satisfied to the question – Overall, how satisfied are you with the care you get from the clinic? Rationale  A measure of the Patient Experience  Satisfied patients tend to take a more active role in their own treatment.  Regular measurement of patients’ experience, including satisfaction, will help PHC organizations make appropriate, evidence based changes to processes to improve patient experience and, ultimately, health outcomes. Confidential – Content not for distribution. 17

3. Percentage of patients answering satisfied or very satisfied continued… Calculation  Numerator – total number of patients answering satisfied or very satisfied to the survey question.  Denominator – total number of patients answering the survey question. Other considerations  The single patient satisfaction results will be the information flowing to AH.  The expectation is that this will be part of a broader patient experience survey.  The specific survey has not been identified.  Consultation with PCNs will be a very important part of the survey selection process. Confidential – Content not for distribution. 18

4. Percent of patients returning to the same provider at the clinic for a subsequent visit Rationale  Evidence shows that individuals who have a continuous relationship with a primary care provider or team:  Receive higher rates of preventive care;  Make fewer visits to the emergency department;  Have lower hospitalization rates;  Experience better management of acute and chronic illness; and  Tend to report increased satisfaction with their care.  This indicator will provide information on the extent of patient continuity.  Can be analyzed along with the underlying data sets to support improved panel management leading to better health outcomes. Confidential – Content not for distribution. 19