Advancing the conversation PCN Measurement Capacity Initiative Project Overview Judith Krajnak & Scott Oddie AHS - Primary and Community Care February 7, 2013
Presentation overview Foundation for this work Goal of PCN Measurement Capacity Initiative (MCI) Key indicators/outcomes in learning modules Stakeholders Working together Other business 2
What is the burning platform? Canada is dead last (along side the US) in its ability to innovate in primary care We know that such innovations enhance health outcomes and cost savings We know what areas require innovation to enhance or redesign primary care We DO NOT know how to do this well in Canada/Alberta 3
What We Can Learn From Others A Scan of Primary Health Care Service Delivery Models (As presented at the Accelerating Primary Care Conference, November 2012) Authors include: staff from AHS, Primary and Community Care, Primary Care Innovation and Integration Team
PHC Redesign Project Objectives: 1. Assess other successful PHC service delivery models 2. Interview key stakeholders on promising practices 3. Analyze findings From 25 leading organizations or jurisdictions, interviewed 5 1. Veterans Health Administration, USA 2. NorWest Community Health Centre, Ontario 3. Southcentral Foundation, Alaska 4. Netherlands 5. Australia Remote/Rural and Aboriginal 5
Eight Value Categories as Themes for Lessons Learned Individual and Family Health Values 1. Individual and Family Focused 2. Wellness 3. Access 4. Integrated 5. Quality and Safety System Values 6. Continuous Improvement 7. Accountable 8. Sustainable 6
Key Findings: What did others have to say to us? 7
Recurring Messages CULTURE DETERMINANTS OF HEALTH 8
Culture Those most successful in making positive and sustainable changes cited the importance of a culture that: Focuses on relationships with individuals and families and with staff Promotes measurement for the purposes of making improvements in care Evident in interviewees passionate, principled leadership committed and dedicated to providers and to the community 9
What DID we learn from others? We can do what others have to transform primary health care we have the information and experience What we have read in the literature and heard through consultation with Albertans has been tried and succeeded in other settings Dependent on A culture of improvement that values relationships Sustained effort Visionary leadership Community driven/engaged/involved 10
History of performance measures development (2005) Accountability Monitoring Evaluation Working Group (Early 2007) PCI Program Evaluation Framework accepted by PCIC, but not implemented (2009 2010) Performance Diligence Indicators program introduced Cancelled in late 2010 (2011) Malatest Report accepted, but not trilaterally released to allow use of findings July 2012 Auditor General Report released 11
Context and timing in AB Need to advance the development of common quality and outcome measures in PC (e.g. OAG recommendation) Timing is right Alberta Health moving ahead with new models (FCCs) and developing PHC Vision & Evaluation Framework Calgary Zone developing PC Action Plan Need to have diverse stakeholders exchange, discuss and examine evidence, perspectives and knowledge relevant to the development of such measures. 12
PCN MCI Goal To advance the collaborative development of common quality and outcome measures in primary care in 5 key areas including: Access (i.e. Third to Next) Patient Report Outcomes (PROMs) (i.e., Health Quality of Life, satisfaction, experience, experience with care planning) Health Team Effectiveness Screening measures for common health risks, CDM and compliance to undertake the screening Value and return on investment (ROI) 13
Three Learning Modules Module 1 Measures of value/cost effectives/roi Module 2 Core measures including: PROMs, health team effectiveness, access, patient satisfaction, experience Module 3 (Starting April) Tools, measures, and indicators to enhance screening of common health risks and chronic disease 14
Who will be around the table? 22 representatives from PCNs (4 zones) including: Executives Directors Evaluators Provider leads 12 PCNs including: McLeod River, Peace River (North) Southside, Oliver, West (Edmonton) Red Deer, Rocky Mountain House, Wolf Creek, Camrose, Wetaskiwin (Central) Bow Valley, Bonnie Wright (Mosaic PCN, representing Pan Calgary Evaluator working group) (Calgary) 15
Who will be around the table? 25 30 stakeholders AHS Zone representatives Academics (business and health) Institute of Health Economics Health Quality Council of AB Alberta Health CIHI 16
Webinars Purpose of webinars to create a common language, allow reporting back and action planning February 14th 11:30am 1:00pm Questions of Value, Cost Effectiveness, and ROI February 20 th 11:30am 1:00pm Access, health team effectiveness, and Patient reported outcome measures (PROMs) 17
Face to face meeting dates Purpose of face to face meetings Share expertise and knowledge Develop common understanding of biggest challenges to implementation Develop action plan to overcoming these Face to face meetings (Best Western Hotel, Leduc, from 9:00am 3:30pm) Setting the Scene for Measures in Alberta March 1 st (Friday) Evidence and Planning March 21 st (Thursday) Infrastructure and Supports April 25 th (Thursday) Implementation at your PCN May 30 th (Thursday) 18
Additional meeting dates Webinar meetings (after February) by experts, reviewing action planning, sharing what we learn March 11 (Monday, 11:30am 1:00pm) March 15 (Friday, 11:30am 1:00pm) April 16 (Tuesday, 11:00am 12:30pm) April 18 (Thursday, 11:00am 12:30pm) May 21 (Tuesday, 11:00am 12:30pm) May 23 (Thursday, 11:30am 1:00pm) * note the slight time adjustment 19
How will we work together? Engage in lively dialogue Understand diverse perspectives Move toward a common understanding Reflection on discussions outside of meetings Be action oriented (e.g., identify actions and next steps) 20
What is my role? PCN Participants Actively engage in this work Share your opinions, and your experiences Be a champion for it back at PCN External stakeholders/collaborative Share your expertise Support this effort, and the PCNs, as you can 21
Next steps Scott & Judith will work to create a learning and trusting environment for all We will be respectful of everyone s commitments and time Implement action plan created in initial meetings e.g. Implement a narrowly focused PDSA type of process to allow first hand learning Share this learning with others as part of this Initiative 22
Final deliverable 23
Reimbursement Travel reimbursement forms will be completed & submitted on March 1 st at first f2f meeting (and same for subsequent meetings) Refer to ground travel chart for rates from PCNs Original receipts will be required Reimbursement will be to individuals not PCNs Travel from PCN together if possible. Hotel shuttle service is available from Edmonton International Airport 24
Other need to know details PCN representatives sign collaborative agreement (Project Agreement) Online library of materials will be available soon 25
In Conclusion: Looking to the future 26
Closing thought One fundamental of evaluation Friend to Groucho Marx: Life is difficult! Marx to Friend: Compared to what? 27
Questions or for more information Judith Krajnak, AHS, Director of Evaluation & Knowledge Application (o) 780-342-8816/(m)780-566-7691 Judith.Krajnak@albertahealthservices.ca Scott Oddie, AHS, Director of Innovation & Evaluation (o) 403-342-3310 Scott.Oddie@albertahealthservices.ca For administrative matters, contact Karena Taskila (o) (403) 343-4076 or via email: Karena.Taskila@rdc.ab.ca 28