STARFIELD FRAMEWORK DEVELOPMENT PROJECT AFHTO’s approach to primary care measurement is based on the Starfield principles. These principles include a focus on the relationship with patients and ability to deliver the comprehensive care patients value. (see The Starfield model: Measuring comprehensive primary care for system benefit). AFHTO has invested recently in an effort to “get started” with membership-wide performance measurement in the form of Data to Decisions 1.0: Advancing Primary care. The next steps for D2D 1.0 are intended to advance meaningful measurement in primary care in a way that is consistent with Starfield principles. The scope of the Starfield framework development project includes a series of activities by AFHTO members and external partners, ranging from confirmation of the theoretical basis to establishing weights for the components of the measures of doctor-patient relationship to developing technical solutions for reporting, analyzing and disseminating data and evaluating the impact on quality of care. Project Coordinator Role Reporting to the Provincial Lead for the QIDS program, the Project Coordinator will play a critical role in delivering on this objective. The role will be responsible for coordinating and aligning the efforts of external partners with AFHTO’s members in a way that leverages the ongoing work of the QIDS program. The specific role of the position includes the following:
- Manage work plan: Under the direction of the Provincial Lead for the QIDS program, the project coordinator will collaboratively develop and implement a detailed work plan focused on incorporating Starfield principles into AFHTO’s ongoing efforts to advance manageable meaningful measurement, based on an existing high-level summary of proposed work streams.
- Recruit partners and participants:
- Facilitate the development and application of criteria by which projects proposed by external partners will be judged for inclusion in the overall work plan, based on each project’s capacity to achieve the goals of the defined work streams.
- Recruit patients, research partners and AFHTO members for relevant roles in the project
- Contribute to positive relationships and effective communications with other QIDS program partners including other primary care providers, research partners, the Ministry, LHINs and related agencies (e.g. HQO, eHealth Ontario, OntarioMD, CIHI) and EMR vendors, among others
- Facilitate access to external funding opportunities: Identify and facilitate applications for opportunities for funding for research program, including tracking revenue and spending
- Communicate:
- Develop and implement communication processes to increase awareness and support of Starfield principles and their importance in demonstrating the value of interprofessional comprehensive, patient-centered primary care
- Provide secretariat support to the Research Advisory Team (Starfield), including providing ongoing progress reports to AFHTO membership and external partners
- Contribute to a culture of learning and continuous improvement in performance measurement within AFHTO member organizations.
High-level work plan
- Validate theoretical constructs of the Composite Indicator of quality (a fundamental component of the approach), including examination of compliance with best practice in constructing composite indicators.
- Recruit primary care teams to participate in an expanded pilot of measurement consistent with Starfield principles.
- Establish a sustainable process for generating “patient expectations”, to be used as weights in the composite indicator
- Establish a sustainable process for generating “threshold” levels for performance on the components of the composite indicator
- Establish a sustainable process for data capture from patient surveys (ie patient experience input), administrative data sources and, where necessary, EMRs.
- Establish a sustainable process for data submission, data management and analysis to generate the scores for composite indicator, capacity and cost.
- Establish a sustainable process aligned with best practices for providing feedback that leads to action on primary care outcomes.
- Evaluate impact of the reporting/feedback process on primary care outcomes in the candidate teams and measurement culture in primary care.