How to Read this Report
What’s being measured?
AHS delivers health services in five zones, each with different populations and geography. The measures presented here track our current and projected performance in a broad range of indicators that span the continuum of care. They include primary care, continuing care, population and public health, and acute (hospital-based) care. Among others, these measures touch upon various dimensions of quality such as timeliness, effectiveness, efficiency, and satisfaction rates.
Assessment of data quality
AHS has initiated a formal process to assess the quality of the performance measures listed in this report, with priority given to the Tier 1 measures highlighted in the 2012-2015 Health Plan. The Data Quality and Operational Readiness (DQOR) review process involves multiple stakeholders in an assessment of the people, processes, and information systems responsible for reporting on a given performance measure which, depending on the measure, can take between three to six months to complete. DQOR assessments have been completed for: Hip and Knee Replacement Surgery Wait Times, ED Length of Stay for both admitted and discharged patients within the higher volume EDs, and Continuing Care Wait Lists and Times.
An informal assessment of data quality has been conducted for all performance measures included in this report. Operational areas were asked to complete a questionnaire using a subset of items from the formal DQOR review process. Where complete, the results of this informal assessment have been translated into one of the following statements:
- An internal review of the data quality indicates a very high level of confidence with no known issues.
- An internal review of the data quality indicates a high level of confidence with limited issues.
- An internal review of the data quality indicates a moderate level of confidence with some known minor issues.
- An internal review of the data quality indicates an acceptable level of confidence with known issues.
- An internal review of the data quality indicates a questionable level of confidence with known issues.
How to read this report
This report contains a high-level system (provincial) dashboard which offers a summary view of AHS performance against the targets we have established for 2012/13. This provincial dashboard shows the target for the 2012/13 year and the actual year-to-date performance for the third quarter ending December 31, 2012. The dashboard also compares the third quarter’s year-to-date performance against the third quarter’s year-to-date performance from last year. In looking at the actual year-to-date performance, if the ‘stretch’ target has been missed, we would still seek to demonstrate improvement over time enabling us to confidently make the right changes to our health system.
- Quarter Three Year-to-Date Actual to Target Comparison: For the third report of the fiscal year, we compare the year-to-date results (April – December, 2012) against the prorated target. The prorated target is where we would expect to be, three quarters of the way through the year as we move from the prior year’s target to the current year’s target at the end of the year.
A green square is used when actual performance is at, or is better than, the prorated target. A yellow triangle represents performance within an acceptable range of the target (the result has moved at least 75 per cent of the way towards where it is expected to be), and a red circle shows where performance is beyond an acceptable range. A green square or yellow triangle can also be changed to a red circle if the trends indicate there is risk of not achieving our performance goals for the end of the year.
Indicators measured annually rather than quarterly are evaluated against the year-end target where performance within 10 per cent of the target is considered an acceptable range, resulting in a yellow triangle.
- Prior Quarterly Year-to-Date Comparison: Here we compare each measure’s year-to-date (April – December, 2012) value to the previous year’s year-to-date value for quarter three. A green up arrow indicates we are doing better. A horizontal green arrow indicates no significant change (within 5 per cent) but that the measure is slightly improving. A horizontal red arrow indicates no significant change (within 5 per cent) but that the measure is moving slightly away from the prior measure and a red down arrow indicates we are not doing as well.
In addition to the provincial dashboard, a zone comparison dashboard has been included to allow for an at-a-glance view of performance against the provincial targets across each zone (the five geographies providing integrated health services).
Individual zone dashboards are included as well (following the same format as the provincial dashboard), which present each zone’s performance against the provincial targets. It should be noted that some performance measures have not been allocated to the zone level due to the nature of a provincial service delivery model.
Following the dashboard views, you also have access to one-page descriptions of each indicator with additional access to detailed definitions, comments on existing performance, actions being taken by AHS to improve performance, more detailed information by zone or site (as appropriate to the specific indicator), and other useful information. Where available, these descriptions have volume graphs included. These graphs have year-to-date volumes for 2010/11, 2011/12 and 2012/13. Under the volumes there is a “per cent change”. This per cent change is the change from 2011/12 year-to-date to 2012/13 year-to-date.
Performance Report Changes for Q3 2012/13
For the Q3 2012/13 Performance Report, the following changes have been made:
- The Introduction to the report has been broken into three sections to improve overall clarity.
- The Provincial and Zone Dashboards have been simplified to focus on the current period results and a year-to-date comparison to last year.
Data availability for quarterly updates varies due to data source differences. All but six of the quarterly performance measures in this report are updated to the third quarter (October – December, 2012) and third quarter year-to-date (April – December, 2012). For those indicators reporting second quarter 2012/13 data (July – September, 2012), the following table explains the reasons for the one quarter reporting lag:
|Quarterly Measures with a One Quarter Reporting Lag||Data Timeline Clarification|
|Patient Satisfaction – Acute Care||
This measure is generated from survey data, where patients are called up to six weeks after they leave the hospital. Data are then prepared and analyzed for reporting. This results in data being available approximately two months after the end of each quarter.
|Patient Satisfaction – Emergency Department||This measure is generated from survey data, where patients are called up to six weeks after their Emergency Department visit. Data are then prepared and analyzed for reporting. This results in data being available approximately two months after the end of each quarter.|
Infection Prevention and Control measures:
|These measures currently undergo a more rigorous internal review process at both the zone and provincial level prior to results being released.|
|30 Day All Cause Unplanned Readmission Rate||Readmission rates are attributed to the quarter in which a patient is originally discharged from a hospital. This requires that patients be tracked for readmission 30 days after the end of a quarter. Data are lagged by a quarter for this reason.|
This report contains the most currently available data for all performance measures. In addition to those measures updated quarterly, several other measures are updated on a less frequent basis. These measures are detailed as follows with a timeline for their next anticipated update:
|Performance Measure||Reporting Frequency||Next Update|
|Life Expectancy||Annual||Q4, 2012/13|
|Potential Years of Life Lost||Annual||Q4, 2012/13|
|Colorectal Cancer Screening Rate||Annual||Q1, 2013/14|
|Breast Cancer Screening Participation Rate||Annual||Q1, 2013/14|
|Cervical Cancer Screening Participation Rate||Annual||Q1, 2013/14|
|Seniors Influenza Immunization Rate||Annual||Q4, 2012/13|
|Children’s Influenza Immunization Rate||Annual||Q4, 2012/13|
|Childhood Immunization Rate for DTaP||Annual||Q4, 2012/13|
|Childhood Immunization Rate for MMR||Annual||Q4, 2012/13|
|Albertans Enrolled in a Primary Care Network||Semi-annual||Q4, 2012/13|
|Rating of Care Nursing Home – Family||Every 3 years||2013/14|
|Staff Overall Engagement||Annual||Q4, 2012/13|
|Medical Staff Overall Engagement||Annual||Q4, 2012/13|
|Patient Satisfaction – Addiction and Mental Health||Annual||Q4, 2012/13|
|Albertans Reporting Unexpected Harm||Annual||Q3, 2013/14|
|Patient Satisfaction – Health Care Personally Received||Annual||Q3, 2013/14|
|Hand Hygiene||Annual||Q3, 2013/14|