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System Performance

How Indicators are Selected to Measure Ontario’s Health System Performance

Health Quality Ontario uses measures known as indicators to track the quality of Ontario’s health system, and sets criteria for the selection of indicators and the process for their selection.

Criteria for Selection


The indicator reflects an issue that is important to the general population of Ontario and to relevant stakeholders in the health system, and is consistent with the mandate of Health Quality Ontario.


There are data sources that can be used to measure the indicator.


The indicator is likely to inform and influence public policy or funding, alter behaviour of health care providers, and/or increase general understanding by the public in order to improve quality of care and population health.


There is good evidence to support the process, or evidence of the importance of the outcome of measuring and reporting on the indicator.


The indicator is calculable; data is timely.


The indicator is clear and can be easily interpreted by a range of audiences; the results of the indicator are comparable and easy to understand, including what constitutes improved performance, such as clear directionality (i.e. a lower number is better).

Data Quality

The indicator includes data quality such as technical definition, calculation methodology, validity and reliability of measurement, and timeliness of data.

Five-Step Process of Selection

Step 1: Preliminary Analysis
  • Suggestions from the public on health care areas to consider for indicator development.
  • Review of existing indicators by Health Quality Ontario.
  • Consultation with subject matter experts, such as health researchers.
Step 2: In-Depth, Expert Analysis

Exploration of the health system data, and wider consultation, happens through a technical expert panel. Consideration is given to whether each indicator can accurately identify high and low performance, using specific criteria.

Step 3: Presentation to External Stakeholders

Indicators that satisfy the expert panel are further developed, including technical specifications and methodology. The indicators are then presented to health care sector stakeholders for additional feedback.

Step 4: Approval for Public Reporting

Once an indicator is approved, further consideration is given to the best public reporting method – straight online reporting of the data within this indicator, plus including it in our yearly report or specialized reports which provide more context. If an indicator is not approved, it is kept on record and further development may be considered.

Step 5: Periodic Review

Indicators are regularly reviewed and may be retired from public reporting if no longer suitable.

Monitoring What Matters

Our approach to measuring and reporting on the performance of Ontario’s health system

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The Common Quality Agenda

A set of indicators to measure health quality in Ontario

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Indicator Library

Technical information on quality indicators; searchable and comparable data

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