Evidence of Value

D2D 4.1: Starting to move beyond measurement

Today’s release of Data to Decisions (D2D) 4.1 contains early signals that variation in performance between teams is decreasing.  Reducing variation is an important goal in quality improvement. So the observed change is an early and encouraging signal that the needle on performance is starting to move in response to measurement.  In the meantime, data from D2D 4.1 continue to show that higher primary care quality is associated with lower total health system cost.

With D2D 4.1, the amount of data teams are able to contribute continues to grow. As with previous iterations of D2D, members are clear that this is due in large part to the network of Quality Improvement Decision Support (QIDS) Partnerships, available to most (but not all) primary care teams. Thanks to these partnerships, voluntary participation is holding steady at about two-thirds of all members. Changes coming soon to address other barriers for participation include:

  • Change the comparator to 75th percentile instead of average values to increase effectiveness of comparison as a driver for change
  • Emphasize the value of ongoing/continuous measurement, even in the absence of specific interventions to improve performance
  • Encourage the USE, not just contribution, of D2D data
  • Clearly communicate updates in Primary Care practice report (data now current to within 6 months compared to 1.5 years previously)
  • Highlight the value of D2D to collective as well team-level efforts to improve

Measurement puts a lens on what does need work.

AFHTO is expanding its collective focus beyond measurement to improvement. Activities offered to support members in efforts to improve performance include:

D2D 4.1 is making collaboration at the LHIN level easier.

100% of teams provided information about their LHIN location. This is consistent with what happened in D2D 4.0 (when LHIN was introduced as a peer characteristics). It is also in line with requests of teams in several LHINs to unmask their identity to others in their own LHIN to make comparisons more meaningful. Sharing information in this way is helping these teams work together with their LHINs on primary care transformation while keeping the focus of measurement on the comprehensive generalist nature of high quality primary care.

The journey towards manageable meaningful measurement and improvement in primary care continues. The next iteration – D2D 5.0 – will be out in the fall of 2017. 

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