Measurement and Quality Improvement

Patients as Partners in Primary Care: A Journey towards Comprehensive Measurement

Ontario’s primary care sector is moving towards a more comprehensive, patient-centered approach to quality health care delivery. To fully understand whether primary care has reached this goal of quality, there needs to be a way to measure both the comprehensiveness and patient-centered aspects of care.

We developed a survey in collaboration with volunteer patient representatives from Patients Canada, incorporating discussions with a broader group of representatives. The main objective was to determine which indicators are most important to patients and in what way. You can learn more about the process here.

This information would then be incorporated into a composite quality “roll-up” indicator, based on performance on common indicators weighted according to their relative priority to patients. The resulting indicator would better reflect the comprehensiveness and patient-centeredness of care.

“Over half of the participants indicated that they want an equal partnership with their doctor when it comes to decision-making around their care.”

Results: An important finding of the survey was that over half of the participants indicated a desire for an equal partnership with their doctor when it comes to decision-making around their care. This validates the original premise that it was important to ask patients what is important to them and further emphasizes the need to incorporate patient input concretely into measurement of quality in primary care.

Importance of indicators to patients

patients as partners handout pic- 2016-01-27

The results show that patients do consider certain indicators more important than others, the most important ones being those related to their experience of being heard and involved in their care. Based on these data, weights were derived to calculate a composite measure of quality which was first included in AFHTO’s membership wide performance measurement report, Data to Decisions (D2D) 2.0.

Conclusion: Overall, this collaborative project was successful in determining what is important to patients and how it is important. The partnership between Patients Canada and AFHTO is continuing through joint submissions to conferences. Future inquiries into patients’ values regarding their care should similarly involve collaboration with patients throughout the entire development and implementation process.

AFHTO is continuing work on measurement in primary care with each iteration of D2D which will include an updated quality “roll-up” indicator with input from patients and doctors.

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