For the past few years, the South West LHIN has been trialing and adapting an approach to understanding the impact of the Health Links approach to care in its sub-regions.
The South West LHIN has been
monitoring a number of process, outcome, and balance measures
for the Health Links approach to Coordinated Care Planning across
the region. Quarterly dashboards track the total number of people in
the LHIN and per sub-region who are supported by Coordinated Care
Planning; progress toward fiscal targets; referral source
sector; and patient and provider experience.
Ontario Health (Quality) had a chance to
catch up Jennifer Mills Beaton, MSc, MPA, Program Lead, Health Links, South West
LHIN, to learn more about the development and use of the quarterly dashboards
and the impact it has had.
When did you first develop the quarterly
dashboards?
About 3 years ago, we developed a quarterly
dashboard as a means for communication, informed decision-making and reporting
purposes with various key stakeholders. These detailed reports allowed us to
track spread, timeliness of process, how we are supporting three priority
populations, outcomes, and patient and provider experience at the South West level
as well as at the sub-regional level.
These dashboards had a lot of information,
and were great at the beginning, with Health Links working groups and steering
committees, but as we transitioned to sub-regions provincially, and focused on
spread, we identified the need for a 1-page version, highlighting key pieces
from the dashboards, which offers valuable insights and tangible data to help
all our partners understand the way in which Coordinated Care Planning is
progressing and having an impact.
The 1-pager has been created to share
progress with steering committees, organizations, sub-regions and the
developing Ontario Health Teams (OHTs) quarterly. The purpose of the 1-pager is
to quickly and simply highlight the impact that Coordinated Care Planning is
having on priority populations, within the different regions and across the
South West -- to inspire ongoing spread and scale at the local level.
Furthermore, it can help support more
informed decision-making for continuous quality improvement related to
Coordinated Care Planning. These 1-pagers are done by sub-region (which align
with the OHTs developing in the South West) and for the South West overall.
What’s included in the 1- page version
of the dashboard?
As shown on the attached sample 1-pagers (South West and Oxford) in the reports, we highlight:
- The number of completed Coordinated Care
Plans over the last 5 quarters, and total overall
- Diversity of referral/identification
sources Impact to Emergency Department (ED) visit rates, hospital admission
rates, and hospital length of stay
The outcomes data has been particularly
well received by system partners. For example, as of Q3 this fiscal (19/20)
outcome data shows in the South West LHIN a:
- 35% decrease in ED visit rate/100 patients
within 3 months and 29% within 6 months of CCP -- # of ED visits, per 100
patients
- 43% decrease in hospital admissions
rates/100 patients within 3 months and 40% decrease within 6 months of CCP
(includes MHA admissions) – based on acute discharges per 100 patients
- Average number of days in hospital
decreased by 4.6 days within 3 months and 6.3 days within 6 months (includes
MHA admissions)
Patient/client/caregiver and provider survey
data is collected in an ongoing manner and is displayed to show feedback
received. This includes patient respect and confidence measures, and provider
overall satisfaction and whether Coordinated Care Planning improved provider
relationships. Patient and provider feedback is an area where the South West
continues to struggle with response rate, despite the various strategies
implemented to capture patient-reported outcomes related to Coordinated Care
Planning.
Nevertheless, we continue to visually
display and share the data, identifying the “n” to give context to the results
(i.e. low survey numbers, may result in feedback results not reflective of the
entire population that are involved in Coordinated Care Planning). We feel that
patient-reported outcomes can provide valuable data to inform us on the
effectiveness of Coordinated Care Planning from a patient’s perspective. We
also include quotes on the 1-pager to share patient and provider perception and
experience, in their voice.
We found it was important to provide
definitions on the back of the 1-pager for all the information that is
displayed on the front. This allows 1-pagers to be distributed and taken to
different stakeholders and ensure that it is clear to all what and how the information
is being reported.
How do you see the dashboard being helpful
in the future?
We have heard from leaders that this type
of reporting, particularly the system impact information (e.g. reduction of
hospital utilization) is important for leading change and driving improvements.
This type of reporting has been used to get buy-in from Health Service
Providers and organizational leadership as OHTs have been developing.
We believe that this type of reporting will
be able to help inform and support decision making and change management within
the OHT environment going forward.