Percentage of home care clients who
received their nursing visit within 5 days
Resource for Indicator Standards (RIS)
Health Analytics Branch, Ministry of Health and Long-Term Care
Indicator description
RIS indicator name
Percentage of home care clients who received their nursing visit within 5 days
Other names for this indicator
•
•
•
Percentage of home care clients who received their nursing visit within 5 days of the date
they were authorized for nursing services
5 day wait time – Nursing visits
Five-day wait time for home care: Nursing visits
Indicator description
Percentage of clients who received CCAC in-home nursing service within five day target.
The indicator calculation is the Number of clients who received nursing service within five
days divided by Total number of clients who received nursing service multiplied by 100.
Accountability agreement(s) or ministry initiative(s) the indicator supports
•
•
•
•
•
Ministry LHIN Accountability Agreement (MLAA), 2015 – 2018
Hospital Service Accountability Agreement (HSAA), 2015 – 2016
Multi-Sector Service Accountability Agreement (MSAA), 2014 – 2017
The Quarterly
Quality Improvement Plan (community care access centre)
Numerator
Data source
Home Care Database (HCD), Ontario Association of Community Care Access Centres
(OACCAC)
Inclusion/exclusion criteria
Includes:
1. Clients received CCAC in-home nursing service within 5 days from service
authorization;
2. Same list of criteria as for the denominator.
Excludes:
1. Same list of criteria as for the denominator.
Calculation
Steps:
1. Calculate wait time as First Service Date – Start Date (Start service authorization date for
each episode of care).
Denominator
Data source
Home Care Database (HCD), Ontario Association of Community Care Access Centres
(OACCAC)
Inclusion/exclusion criteria
Includes:
1. Clients requested in-home program at the time of referral (Request Program = 1);
2. Clients received in-home service (SRC = 91 to 95);
3. Clients received nursing services (Service Type = 1, 17,18);
4. Age at service authorization date is greater than 18.
Excludes:
1. Shift nursing (Service Type = 2);
2. Mental health and addiction nursing service, which is a service delivered in school setting
for children (Service Type = 16);
3. Children receiving nursing service (Age <= 18);
4. Service delivered in school setting (Care Site = 12, 24, 25);
5. Episodes of care where service on hold date falls between the service authorization date
and first service date.
2
Calculation
Steps:
1. Prepare an episode of care file:
a. Restrict service authorization file to nursing service (Service Type = 1, 17, 18);
b. Assign Care Authorization Date as Start Date and Care Discharge Date as End
Date; open cases are assigned to future date of ‘1JAN2099’d;
c. Consolidate overlapping service authorization records to create distinct episodes
of care.
2. Link each episode of care to service table using the following logic:
a. Intake ID = Intake ID;
b. Service Type is Nursing (1,17,18);
c. Service Date is BETWEEN Episode of care Start Date and End Date
d. Output first service record for each episode of care.
3. Define cohort:
a. Clients received in-home service (SRC = 91 to 95);
b. Service is delivered in in-home setting (Care Site NOT equal to 12,24,25);
c. Age at Start Date of episode of care is greater than 18.
4. Remove service on-hold clients:
a. Link cohort to On Hold table using IDS Client ID;
b. Remove all episodes of care where On Hold dates fall between the service
authorization and first service date.
5. Calculate percent of clients within 5 day wait time target as total number of CCAC
clients receiving in-home nursing services within 0 to 5 days from service authorization
in a given time period divided by total number of CCAC clients receiving in-home
nursing services in a given time period) multiplied by 100.
Timing and geography
Timing/frequency of release
How often and when data are being released (e.g., be as specific as possible…data are
released annually in mid-May)
Data by fiscal year are available annually.
Trending
Years available for trending
Data for this indicator are available from Q3 2012/13 as this is when service authorization
dates became mandatory.
Levels of comparability
Levels of geography for comparison
Data are available at LHIN level.
3
Additional information
Limitations
Specific limitations
Clients requiring shift nursing are generally from highly complex children population with
very special needs and comprise a proportionately small volume. As such, shift nursing is
excluded in the calculation of this indicator.
For many clients, home care assessment occurs over a process rather than on a single date. A
number of possible dates could be used to measure assessment, including the date of the
initial assessment, which begins the assessment stage, or the service authorization date, which
is the logical outcome and conclusion of the assessment stage. The Home Care Wait Time
Implementation Task Group recommended the use of service authorization date.
Using service authorization date for wait time analysis includes three different client
populations: (1) new clients; (2) existing clients who now require a new service, and; (3)
existing clients who are receiving services after a break in service. Each client population is
considered a unique episode of care. Clients may have multiple episodes of care as they
transition across the health care system. The first nursing service post each episode of care is
included.
Comments
Additional information regarding the calculation, interpretation, data source, etc.
N/A
References
Provide URLs of any key references (e.g., Diabetes in Canada, HTTP:// …)
N/A
Contact information
For more information about this indicator, please contact RIS@ontario.ca.
Date RIS document created (YYYY-MM-DD)
2015-09-16
Date last reviewed (YYYY-MM-DD)
2016-02-03
4