Measurement and Quality Improvement

Data to Decisions: What Difference is it Making?

“We felt that it was the best way to see where we rate according to other teams to use for improvement work within our team”- AFHTO Member

Data to Decisions (D2D) is a summary of the performance of primary care teams across Ontario on a small number of indicators that are both meaningful to providers and possible to measure. D2D is grounded in Ontario’s Primary Care Performance Measurement Framework (PCPMF) and reflects Barbara Starfield’s principles of comprehensive, patient-centered care.

It’s intended to help members compare their performance to that of peers, focus local improvement efforts and also give primary care teams a voice in the future of performance measurement in primary care.

A project of the Association of Family Health Teams of Ontario (AFHTO), D2D was made possible through the investment in more than 30 Quality Improvement Decision Support Specialists (QIDS Specialists) across Ontario.


Following the release of the second iteration of the D2D report in June 2015, AFHTO began a developmental evaluation to collaboratively understand and increase the impact of D2D on:

  • Participation in Performance Measurement
  • Access to Data
  • Use of Data
  • Quality of Care


  • Team characteristics: Better scores on team climate and changes in QI goal orientation
  • EMR use: Increased data standardization despite no change in EMR functionality
  • QI activity: More conversations with physicians and board re: QI and performance
  • Physician ambassadors: associated with better team characteristics
  • Performance on processes/outcomes of care: No change on the core D2D indicators (old data, 8 month interval)

Learn more about selected findings to date here.


The D2D journey continues with release of D2D 3.0 in January 2016. The focus is on increasing participation and encouraging teams to make decisions from data. To that end, AFHTO is assembling strategies for improvement that are aligned with the way teams work to achieve their goals.

The information on this page is also available as a pdf here.