How Performance will be Measured & Monitored


The Central West LHIN will monitor and report on the success of IHSP 4 through a balanced scorecard. This collection of measures presents a useful indication of the performance of the local health system, the LHIN itself and of local Health Service Providers.

In alignment with Patients First, the Central West LHIN`s balanced scorecard is organized into four perspectives, building from foundations to the outcome of patient experience. These perspectives include:

  • Resident Experience
  • Value
  • System Performance
  • Learning & Growth

The Central West LHIN is accountable to the Ministry of Health and Long-Term Care through the Ministry-LHIN Accountability Agreement (MLAA). All LHINs are measured against the same provincial targets. The MLAA sets out three types of targeted performance measures, including:

  • 14 Performance measures
  • 8 Monitoring measures
  • 2 Developmental measures.

The Central West LHIN has established a local balanced scorecard which encompasses these MLAA measures (Figure 3). In addition, the scorecard has been developed to include some measures that reflect the Strategic Directions, Initiatives and Actions in the IHSP and support the elements that define success. In addition to the Central West LHIN`s existing commitments to public reporting, open and transparent Board meetings and decisions, and the Annual Business Plan and Annual Report processes, the Central West LHIN will monitor and report on IHSP 4 success through the scorecard outlined below. This collection of measures presents a useful indication of the performance of the local health system, the LHIN itself and of local Health Service Providers.

The Central West LHIN`s balanced scorecard is organized into four perspectives, building from foundations to the outcome of patient experience. The perspectives are:

  • Resident Experience (patient point of view) | Includes wait time and length of stay measures as well as a measure of patient satisfaction.
  • Value (financial point of view) | Includes measures of avoidable interaction with the health care system.
  • System Performance (system point of view) | Includes measures of proportion of LHIN population receiving care within provincial targets.
  • Learning & Growth (provider point of view) | Includes measures of Health Service Provider alignment with local and provincial initiatives.

The balanced scorecard is monitored and reviewed quarterly by the LHIN’s Board of Directors and actions are targeted to improve performance where warranted and ensure a system that is accountable to funders and the community. Specific measures within the balanced scorecard may be modified during the period of the IHSP to align with changing Ministry-LHIN accountability measures, and to potential updates of provincial and local priorities.

The Central West LHIN establishes Annual Business Plans each year. These plans outline what specific actions the LHIN will take in each of the three years of the IHSP to implement the Strategic Directions and Initiatives in the IHSP and how it will measure the progress of each initiative. To ensure transparency and accountability to the community, this progress is reported in the LHIN’s Annual Report, specifically reporting on the LHIN’s progress with each performance measure, both those in the Ministry-LHIN Accountability Agreement and those specifically developed to reflect progress with the IHSP.

LHIN Resident Experience

  1. 90th percentile ED length of stay for low acuity patients
  2. 90th percentile ED length of stay for high acuity patients
  3. % ALC days (patient days in acute beds)
  4. 90th percentile CCAC wait time (acute LTC assessment)
  5. 90th percentile CCAC wait time (community LTC assessment)
  6. 90th percentile CCAC wait time (community in-home services)
  7. Overall satisfaction with health care in the community

Value (Quality/$)

  1. Rate of emergency visits best managed elsewhere
  2. Repeat emergency visits within 30 days for mental health conditions
  3. Repeat emergency visits within 30 days for substance abuse conditions
  4. Hospitalization rate for ambulatory care sensitive conditions
  5. Readmission within 30 days for chronic diseases (HIG conditions)
  6. ALC rate (bed days in all beds)

System Performance

  1. % within target: with access to primary care (next day)
  2. % within target: home care PSW (5 days)
  3. % within target: home care nursing (5 days)
  4. Proportion within target: 6 wait time indicators
  5. % within target: patients acute discharge MD (7 days)
  6. Proportion within target: 3 nosocomial infection indicators
  7. Proportion within target: 2 falls indicators
  8. % within target: palliative care patients discharged from the hospital with home support

Learning & Growth

  1. % organizations that actively search the IAR
  2. Proportion of HSP’s that are accredited
  3. Proportion of HSP’s that have developed and implemented Quality Improvement Plans