Quality is an integral part of Toronto Central LHIN’s Strategic Plan and Integrated Health Service Plan, reflected in the goal, Better health outcomes for people through equitable access to quality care. Toronto Central LHIN has created a system approach to quality and undertaken a significant initiative (under the guidance of the Toronto Central LHIN Quality Table) to begin a comprehensive approach to measuring quality, incorporating equity and ensuring the primacy of the patient experience in our collective understanding of quality. The commitment to quality extends through the organization and across its health service providers. Toronto Central LHIN’s quality initiative is closely aligned to key strategic provincial directions such as the Ministry of Health and Long-Term Care’s Action Plan for Health Care, the Excellent Care for All Act, Health Quality Ontario Common Quality Agenda and Health Links.
The quality initiative is led and guided by the Toronto Central LHIN Quality Table (formerly Quality Indicators Task Group). It is comprised of representatives from all six LHIN-funded sectors, primary care, public health, the Ministry of Health and Long-Term Care, Health Quality Ontario, Ontario Hospital Association, Regional Geriatric Program, GTA Rehab Network, frontline and other providers, and also includes a patient and a caregiver.
System Quality Indicators
To address the lack of system-wide quality indicators, Toronto Central LHIN developed a framework and criteria for selecting the indicators, identified themes to focus on and selected six big dot (system indicators).
The overarching theme is to improve the overall health status of people living within the Toronto Central LHIN as well those who reside outside the LHIN who receive care from our health service providers, and to improve outcomes and experience of care.
Three inter-related themes identified by the TC LHIN Quality Table:
1. Appropriate Access to Care - Focus on avoidable time in hospital
- Avoidable inpatient time
- Avoidable emergency department use
2. Transitions of Care - Focus on patient experience
- Communication/information transfer to patient during transition
- Timeliness of hand-off transition communication between providers
3. Care for Patients with Complex and High Care Needs
- Appropriate management of patients with complex high care needs
The Quality Table subgroups then selected related sector specific indicators. Technical specifications for the indicators have been developed and data collection and monitoring of the indicators is currently underway. The Quality Table and sectors are reviewing the resulting information to identify best practices to improve performance of the indicators.
Toronto Central LHIN Quality Indicators
First Report of the Quality Indicators Task Group
Briefing Note - Improving Quality at Toronto Central LHIN: 2012/13 Year in Review
Patient experience is a key element of understanding quality care. Since 2012/13, the LHIN has worked to improve measuring and reporting of the patient experiences and, in particular, those patients who we don’t hear from regularly or who may be underserved. A current state assessment among TC LHIN providers showed there is lack of standardization in the measurement of patient experience. Each organization and sector works in silos to measure and improve quality. TC LHIN is exploring a range of opportunities that arose from this current state assessment. For instance, the development of a common survey tool to evaluate client satisfaction in community support services for seniors and the implementation of an email-based patient experience survey tool in some organizations.
Standardized Discharge Summary
In 2012/13, organizations in the TC LHIN, under the leadership of the GTA Health Information Collaborative, committed to the development of a standardized discharge summary template. Recognizing the significance of a discharge summary for patients, primary care practitioners in the community and other care providers, the hospitals committed to developing a consistent standardized set of fields. A standard discharge summary template was approved in February 2013, and all TC LHIN hospitals have agreed to implement this template, where possible electronically, in 2013/14.