Championing Innovation in Quality Improvement Decision Support

The Association of Family Health Teams of Ontario (AFHTO) is pleased to announce the six recipients of Quality Improvement Decision Support (QIDS) Innovation Funds. Ontario Family Health Teams (FHTs) are committed to measuring and improving comprehensive primary care performance; the QIDS program is a provincial initiative to support AFHTO members in their quality improvement (QI) efforts.

More than 25 FHTs are involved in these six member-led projects. The projects will serve as catalysts for sector-wide capacity building in advanced measurement and improvement capability. The grant recipients are accelerating progress in the use of data management tools and techniques, implementation of multi-practice performance measurement and feedback, and other QI strategic priorities.

AFHTO is excited to support this cutting edge QI innovation in primary care, and will facilitate knowledge sharing and dissemination of award winners’ lessons learned and best practices among all members. The six grant recipients are as follows; scroll below for more detailed information:

  • Building QIDS capacity through pilot testing of the Starfield Model
    • Leads: Dr. Rick Glazier, St. Michael’s Hospital Academic Family Health Team and ICES and Dr. George Southey, Dorval Medical FHT
  • Readiness and prioritization assessment for adoption and implementation of a minimal clinical data set
    • Lead:  Mary Keith, Executive Director, Garden City Family Health Team
  • Performance Management Framework and Dashboard- A data storybook and performance song sheet!
    • Lead: Heba Sadek, Executive Director, Queen’s Square Family Health Team
  • Patient Encounter and Reporting Tracking System for primary care quality improvement reporting
    • Lead: Michelle Karker, Executive Director, East Wellington Family Health Team
  • QIDS based information management clusters:  leveraging privacy infrastructure, standardized EMR data and scalable analytic tools for groups of Family Health Teams
    • Lead: Dr. Michelle Griever, North York Family Health Team
  • Creating the tools for fostering a culture of quality improvement in Family Health Teams
    • Lead: Dr. Sanjeev Goel, Wise Elephant Downtown Brampton Family Health Team

Background The QIDS Innovation Fund is intended to advance measurement and improvement capacity to enable all members to benefit from better tools, knowledge and capability. An invitation to apply for the QIDS Innovation Fund was extended in December 2013, and members responded with 18 proposals that addressed these goals and then some! This impressive response by members signifies the widespread commitment to quality improvement by the sector.  

Given the wealth of proposal submissions, the selection process was very difficult. Once again, the AFHTO Board would like to thank and congratulate all those who took the time to submit proposals. A special thanks goes to the review panel, which was chaired by Ross Kirkconnell, Executive Director, Guelph FHT and included Brenda Fraser, Central West Local Health Integration Network (well known to many from her work at the Quality Improvement and Innovation Partnership) and Dr. Darren Larsen of OntarioMD and the Ontario Medical Association.

AFHTO would also like to acknowledge and express its sincere thanks to the Ministry of Health and Long-Term Care for the flexibility and support that permitted the provincial QIDS program funding to be allocated in this novel and creative way.

Grant recipients

Building QIDS capacity through pilot testing of the Starfield Model

Leads: Dr. Rick Glazier, St. Michael’s Hospital Academic FHT and ICES and Dr. George Southey, Dorval Medical FHT

The goal of this project is to pilot the Starfield Model, a measurement framework for comprehensive primary care based on the principles enunciated by Barbara Starfield and endorsed by AFHTO. The project will directly support AFHTO’s strategic goals by building capacity to measure key elements of comprehensive primary care. Many of the required measures are only beginning to become available and few are in routine use across FHTs or other models of primary care in Ontario. Pilot testing will identify areas of commonalities and differences in measures and approaches and will contribute to further development and standardization.

Readiness and prioritization assessment for adoption and implementation of a minimal clinical data set

Lead:  Mary Keith, Executive Director, Garden City FHT

This is a project aimed at determining both the readiness and priorities of the various FHTs in LHIN 4 regarding a minimum measurable set of data items needed to track specific chronic conditions. Data collection will occur through an online questionnaire. Results of the MDS project should be ready by mid April 2014 and will provide our group with metrics for care management that will assist in the planning and implementation of projects for quality improvement in patient care.This project is being led by Mary Keith, with the assistance of Urslin Fevrier-Thomas and Karl Langton, both from the Hamilton FHT.

Performance Management Framework and Dashboard- A data storybook and performance song sheet!

Lead: Heba Sadek, Executive Director, Queen’s Square FHT

In the absence of a structural tool that enables organizations to organize and understand their accountability requirements, the response to quality initiatives can be frustrating and ad hoc. Through this initiative Queen Square and its partners: Dufferin Area, Halton Hills and North Peel FHTs will identify a common framework for data mapping that will show how different indicators are used to meet different accountability requirements. Clinicians’ input will also be sought in indicator development and standardization that meets their needs and aligns with the Primary Care Performance Framework.

Patient Encounter and Reporting Tracking System for primary care quality improvement reporting

Lead: Michelle Karker, Executive Director, East Wellington FHT

The East Wellington FHT (EWFHT) has been a leader in the development of tools to extract data from its EMR, including data that is now required for Quality Improvement Plans and Ministry reporting. Advanced prototypes are already in existence. This project funding will enable EWFHT to further refine the programming and respond to the requests to share these tools across with its QIDS partners and potentially across the province.

QIDS based information management clusters:  leveraging privacy infrastructure, standardized EMR data and scalable analytic tools for groups of FHTs

Lead: Dr. Michelle Griever, North York FHT

This project will collaboratively develop methods to implement centralized information management for each cluster within a partnership that includes Kingston, Hamilton and North York FHT clusters. The aim is to allow the QIDS Specialist to manage data for several affiliated FHTs from a single secure location, while respecting privacy. The project will develop a customizable, agreed-upon memorandum of understanding for data use, a privacy and security manual compliant with legislation, and secure processes for rolling out reporting software controlled through each cluster's governance policies.

Creating the tools for fostering a culture of quality improvement in FHTs

Lead: Dr. Sanjeev Goel, Wise Elephant Downtown Brampton FHT

The goal of this project is to enhance a current reporting dashboard platform to enable all FHTs from across the province, irrespective of their EMRs, to contribute their data on a set of defined, extractable core indicators. The project will use these core indicators, create innovative solutions for FHTs to contribute this data securely, and then present this data back to FHTs for their consumption.  Access to their own data along with aggregate data from other FHTs will stimulate groups to advance their quality improvement plans. Aggregate data from FHTs will also enable global reporting on FHT performance on these indicators, allowing AFHTO to evaluate current team-based models of care and advocate for scale up of models that are leading to improved health outcomes and health care system sustainability.

For more information on any of these projects, please contact improve@afhto.ca.