Health System Performance
Reporting at CIHI:
A Pan-Canadian Initiative
Atlantic Health Quality and Patient Safety
Learning Exchange May 14th, 15th 2013
Jeanie Lacroix, Manager Performance Improvement
and Capacity Building, CIHI
1
What is the HSP Reporting Initiative?
• Three-year plan (2012 to 2015) to strengthen panCanadian health system performance (HSP) reporting;
• Builds on more than 10-years of experience in
indicator development and public reporting on HSP.
2
Why?
Recent cross-country consultations suggest there is:
• confusion about performance measurement;
• a large number of organizations reporting at various
levels and in an uncoordinated fashion;
• a need to clarify and better position HSP public
reporting.
3
Our Approach:
Integration of HSP Measurement and Peer Learning
4
Five Deliverable Packages Over Three Years
Package
Objectives
Current Projects
HSP measurement
framework
Strengthen evidence base, improve
alignment and make it actionable
• Redeveloped HSP and facility
measurement frameworks
Interactive HSP
public reporting
• Interactive Website for the Public
• Regional website
Deliver cascading sets of HSP reports • Facility-level reporting – hospitals and
over 3 years
LTC
• Indicator Repository
• Patient Experience Survey
Integrated analytical
environment
Analytical capacity to better
understand health system
performance drivers
• Integrated eReporting Solution for
Facility-Level Reporting
 CEHQ Mobile App
Research and
analysis activities
Further align CIHI research and
analytical agenda with priorities of
P/T; strengthen collaboration
• Analytical plan aligned with HSP
framework
• Indicator development
Capacity building
activities
Support capacity building in use of
data
• Pilot HSP school
5
Collaboration and Engagement with Multiple
Stakeholders
Partnerships and Engagement with Stakeholders Across Canada
CIHI External
Strategic Analytical
Advisory Cttee
Consultation with
Public/Patients,
System Managers
Review/provide
strategic advice on
health system
performance work
Identify health
system performance
information needs
Ensure information is
actionable and
relevant
Determine how to
present information
in a meaningful way
Collaboration with
Key Stakeholders
(ministries, HQCs, etc.)
Expert Advisory
Groups
Align research and
analytical work to
support system
improvement efforts
Framework
validation, indicator
selection,
methodological
advice
6
Research and Analysis Activities
Area
Analytical Work
Upcoming analytical products
related to health system
performance
April–July, 2013
• End of Life Hospital Care for Cancer Patients
(April, 2013)
• Health Indicators (May, 2013)
• Distributional Effects of Publicly Financed
Health Care (May, 2013)
• Revisions Following Primary Hip Arthroplasty
(July, 2013)
Patient Experience Survey
(Acute Care)
• Cognitive testing completed
• Pilot testing volunteer recruitment
New Indicator Development
• Harmful Incidents – ongoing work to develop
a national definition
• Hospital Infections – Sepsis, superbug,
surgical-site infections
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Patient Experience
CIHI leading development of pan-Canadian acute care
inpatient experiences survey
Stage of Development:
• Cognitive Test Phase – Jan to March 2013
• Draft questions from new survey undergoing cognitive
testing in 3 provinces
• Pilot test phase – to be completed by June 2013
Next Steps:
Phase II Implementation: Consultations/discussions with
provinces/stakeholders to commence summer 2013
8
Patient Safety – Infections measures
• Rate of VRE, MRSA, C.difficile indicator: measures the
rate of challenging infections caused by three major
pathogens: MRSA, VRE, and C.difficile and is relevant to all
stakeholders at the hospital, regional and provincial level.
• Sepsis Indicators: Two Sepsis related indicators measuring
the rate of in-hospital sepsis and sepsis mortality. They will
provide info on how well and how timely sepsis infections are
prevented identified and treated and the quality of care for
sepsis patients.
• Stage of Development: Literature reviews and analytic
plans developed.
• Next Steps: Identify and engage experts, define inclusion
and exclusion criteria, explore data comparability, develop
risk adjustment methodology.
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Patient Safety - Surgical Site Infections
Definition: measures the rate of infections following specific
interventions within 30 days of intervention. Reported at the
hospital, peer, regional and provincial levels.
Stage of Development: currently being developed as a
subset of larger harmful incidents indicator.
• Literature review underway
• Examining intervention codes and infection codes
• Analytic plan finalized
Next Steps: Identify inclusion/exclusion criteria, explore data
comparability across years and levels of reporting, Develop
risk adjustment methodology
10
Questions?
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