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Measuring Primary Care Performance: Our First Milestone

A couple weeks ago we completed phase one of our Primary Care Performance Measurement (PCPM) initiative.

This framework will help us measure primary care performance, both at the practice and system levels. As anyone committed to quality improvement knows measurement is a critical step. As management guru Peter Drucker is credited with saying “If you don’t measure you can’t report, and if you can’t report you can’t change”.

Beyond the contribution to measurement there are two other elements of this initiative that I am particularly proud about. The first is that the focus is the primary care sector. Admitting my bias as a family doctor, I do believe that Primary Care is the cornerstone of an effective health care system. It is also a very large and varied sector. There are thousands of primary care providers across Ontario providing a broad range of care. Some providers work alone, others in large groups of several dozen. The ability to provide needed tools for the sector is a key activity for HQO and the PCPM is but one example.

The second pride inducing element of this initiative has been the journey to get to this stage. I often talk about quality improvement being a team game and about sustained effort. This accomplishment represents two years of hard work. Starting in 2012 a steering committee comprised of primary care providers, data holders, researchers, policymakers and health sector stakeholders, can together to start this journey (the specific partners are listed below).

They came because they recognized a need for more consistent methods of data collection to improve quality of care. They also observed frustrations among primary care providers level who felt challenged when it came to effectively using data generated from their own clinical and administrative systems in order to improve the quality of care they provide. Most practices still lack the capacity to generate their own performance data, and of those practices that can collect and analyze individual data, many have had almost no feedback on performance. The PCPM initiative, and its subsequent framework, was born out of the recognition that this information is critical to drive improvement.

But how do we drive improvement? Monitoring and measuring performance promotes progress. Progress, in turn, fuels better care and health outcomes.

The Primary Care Performance Measurement Framework provides a rich source of primary care performance domains and measures. Each domain has a set of measurement priorities, and each measurement priority includes a set of recommended measures at the practice and system levels. You can find out more about the framework and the committee’s recommendations in our detailed report.

I acknowledged that this was a first step. Next the steering committee is undertaking a prioritization exercise to identify how primary care providers can seize opportunities to be more efficient at promoting the triple aim of better health outcomes, better care, better value.

I will be back with more on these next steps in the months ahead and other primary care related initiatives. Please feel free to contact me and to follow us on twitter @HQOntario or personally @DrJoshuaTepper

Organizations we are gratefully partnering with as part of the PCPM: Association of Family Health Teams of Ontario, Association of Ontario Health Centres, Bruyère Research Institute, Canadian Institute for Health Information, Cancer Care Ontario, Cancer Quality Council of Ontario, C-CHANGE Initiative, eHealth Ontario, Institute for Clinical Evaluative Sciences, Ontario Association of Community Care Access Centres, Ontario College of Family Physicians, Ontario Hospital Association, Ontario Medical Association, OntarioMD, Ontario Ministry of Health and Long-Term Care’s Health Analytics, Health Quality, Primary Health Care branches, Ontario Patient Relations Association, Patients Canada, Registered Nurses’ Association of Ontario, and South East Local Health Integration Network.

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