Cypress Health Region care quality now measured via on-line dashboard

Elisabeth Dowson
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Cypress Health Region is Saskatchewan's first health region to have its dashboard of quality of care indicators published on the Health Quality Council's Quality Insight website.

Quality Insight is a web-based reporting tool designed to give everyone – the public, providers, managers, and leaders – access to information about how the health system is performing to support quality improvement work that will improve the system for Saskatchewan residents.

The health quality indicators dashboard provides an overview of performance for the entire health region, much as a vehicle dashboard gives information at a glance to the operator, showing where a health system is performing well and where there may be room for improvement.

These indicators can serve as prompts for health care providers, managers and leaders to investigate the results, identify the contributing factors and then implement improvements to quality of care.

Starting with data collected in Sept. 2009, the dashboard contains two years of data measuring quality of care satisfaction. The data from the Saskatchewan Health Quality Council is posted on their website, www.qualityinsight.ca. To see the new dashboard, click on the Cypress Health Region.

Rosemary Gray, Program Director, Saskatchewan Health Quality Council, explained, "When we went live with the first version of the Quality Insight website in February of this year … there was a lot of interest … in how you could start to use it more effectively to really support strategic reporting of key indicators that help the system to know what it’s doing to meet the province’s strategic direction and the local region’s strategic direction.

“In the spring, after they’d had a chance to take a look at some of the content on the website, they approached us and we started to talk about what the realm of the possible might be, and identified the creation of a dashboard as a good starting point, so it was really a collaborative effort and Cypress is leading the way for the province in identifying key indicators to publish, transparently, on a publicly available website, and we’re really looking forward to where we go from here.

“What makes the Cypress dashboard different is that it’s a subset of indicators from that 100, that really allow the Board and the leadership and providers in the region to get an at-a-glance view of the key strategic performance indicators that are important to them as a region.

"This is not a prototype," Gray explained. "This is actually a new way of working for the health system, to be more transparent, to offer data in a format … to drive and stimulate efforts and … to show data over time and show where we’re doing well and where there are opportunities for improvement."

Beth Adashynski, Executive Director of Quality and Privacy in Cypress Health Region, said the Quality Insight website was the logical home for their dashboard since it already contains data on many of the quality measures the RHA's board and managers are paying attention to.

“The Ministry of Health has set out a direction and indicators that we need to monitor. We hope, as we expand the indicators that we put up there, that we will touch all of the areas that we provide service in.

"This reduces the time and energy our board and staff have to spend finding the data they need to make decisions about how we organize and deliver care," said Adashynski. "Having all of our data together in one spot on Quality Insight also helps us be transparent about the quality of care in our health region.

“This is just a start. This is the first baby step for us.”

In terms of having data misinterpreted by the general public, Adashynski feels that is an important part of the interpretive process.

“When you’re putting something out there and you want to be transparent, you really want people to understand what it’s all about. Unless we get it out there, we won’t have those questions come back, and we won’t know whether or not they really understand it. We have to get people to start asking the questions."

The indicators are much more than numbers or a point on a graph.

“The amount of work and the amount of information behind getting that information together to make sure it’s actually going to give us something we can use, because if it doesn’t mean anything and we’re not collecting the right information, we’ll get an answer that we think is right, but it’s not right for what we need to work on.

"What we have on the website may not be used at all levels to make changes, but it right now is a snap shot. It’s something the Board can go in and look at. It starts the questions, which helps us then move down and get more information."

The dashboard reflects data collected from Cypress Regional Hospital, Herbert and District Integrated Healthcare Facility, Maple Creek Hospital, plus the Shaunavon Hospital and Care Centre.

Cypress' new dashboard currently has the following indicators:

• Percentage of acute care beds occupied by patients approved for a long-term care placement;

• Percentage of residents in the region’s long-term care facilities who fell in the last 30 days;

• Falls rate per 1000 long-term care residents;

• Percentage of falls causing injury in long-term care residents;

• Percentage of newly admitted long-term care residents with a Falls Risk Assessment Completed;

• Percentage of long-term care residents who are physically restrained on a daily basis;

• Percentage of surgeries performed where the surgical safety checklist was completed;

• Percent of patients who rated their hospital as 10 out of 10;

• Percent of patients reporting they would definitely recommend the hospital to family and friends;

• Patient Experience - Quality of communication with doctors;

• Patient Experience – Quality of communication with nurses;

• Percent of current surgery wait times exceeding 12 months; and,

• Hospital Standardized Mortality Ratio.

As the Cypress Health Region continues to identify key priority improvement areas, more Cypress-specific indicators are being developed, or adapted from indicators used elsewhere, and added to the region’s dashboard.

Data for all indicators on Quality Insight are updated regularly, allowing users to see performance – and any trends – over time. Additionally, Health Quality Council and Cypress Health Region are collaborating to develop the capability of regional staff, leaders, and managers in incorporating the measurement of quality and the interpretation of data into their daily routine.

“Cypress Health Region has demonstrated the value of Quality Insight in supporting health regions’ efforts to improve care,” says Dr. Susan Shaw, Chair of the Health Quality Council. “Cypress has led the way in publishing key indicators on this provincial resource so they can monitor the impact of the improvement efforts they are making. Other regions are watching this work in Cypress, and we are already talking to several who want to add their key indicators – dashboards – to Quality Insight.”

"When we’re able to put data in front of clinicians, that’s probably one of the most powerful tools we can use for them to understand where we’re at," said Beth Vachon, CEO, Cypress Health Region. "They need to know what the baseline is, what the target is that we’re trying to get to , and then they have the answers on how we make those improvements because they’re the experts in the work that they do.

"People who work in the medical field are scientists. They’re data driven. They appreciate that, so this is a great opportunity for us to start using information more effectively in how we make decisions within our organization. It’s also important that our Board and the public have access to that information."

Organizations: Saskatchewan Health Quality Council, Cypress Health Region

Geographic location: Saskatchewan, southwest Saskatchewan

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