Clinical Utilization and Outcomes
The Niagara Health System is an active participant in the Ontario Hospital Report Card series, with a goal to evaluate hospital care and services and to report to the public how our health-care system is functioning. Hospital Report identifies high-performing hospitals within specific areas, such as acute care or rehabilitation.
The NHS is a High Performer in the Clinical Utilization and Outcomes category, which looks at performance from the point of view of number of readmissions, number of adverse events and appropriateness of care, to name a few. These and other clinical indicators help to explain the amount of care hospitals provide (utilization) and the quality of that care (outcome).
To be rated as a High Performer for Utilization & Outcomes Acute Care, the NHS had to achieve a better-than-average rating on two out of seven indicators (see charts below) and no lower-than-average ratings. The NHS is one of only two Ontario hospitals in the 2008 Hospital Report rated a High Performer in the Utilization & Outcomes Acute Care quadrant
Hospital Report: Clinical Utilization and Outcome Indicators April 2009 (see PDF)
Acute Care
Access to Angiography
Source of Data:
Hospital Report
Reporting Cycle:
Annual
Definitions:
The proportion of patients who received appropriate heart related services following a heart attack while in hospital.
More specifically it is the rate of patients with acute myocardial infarction (AMI) who receive coronary angiography within the episode of care.
Comments
Access rate improved in 2006-07. The NHS average annual rate continues to be within the mean of the provincial average.
The NHS was recognized as a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report for the 2006-07 data.
This indicator is used in the determination of a hospital being a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report. A hospital must obtain a better than average rating on 2 out of 7 indicators and no lower-than-average rating.
Readmissions – Specific Medical Conditions
Source of Data:
Hospital Report
Reporting Cycle:
Annual
Definitions:
The proportion of medical patients who returned unexpectedly to the hospital for reasons that might be related to the care provided during their initial hospital stay.
The readmission rates are for AMI (acute myocardial infarction), heart failure, asthma, GI (gastro-intestinal) bleed, and stroke patients.
Comments
NHS readmission rate improved in 2006-07. The current average rate is better than the mean of the provincial average.
The NHS was recognized as a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report for the 2006-07 data.
This indicator is used in the determination of a hospital being a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report. A hospital must obtain a better than average rating on 2 out of 7 indicators and no lower-than-average rating.
Readmissions – Specific Surgical Procedures
Source of Data:
Hospital Report
Reporting Cycle:
Annual
Definitions:
The proportion of surgical patients who returned unexpectedly to the hospital for reasons that might be related to the care provided during their initial hospital stay.
These readmission rates are for cholecystectomy, hysterectomy, and prostatectomy patients.
Comments
Readmission rate increased slightly in 2006-07. The average NHS rate continues to be within the mean of the provincial average.
The NHS was recognized as a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report for the 2006-07 data.
This indicator is used in the determination of a hospital being a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report. A hospital must obtain a better than average rating on 2 out of 7 indicators and no lower-than-average rating.
Readmissions – Labour and Delivery
Source of Data:
Hospital Report
Reporting Cycle:
Annual
Definitions:
The proportion of labour and delivery patients who returned unexpectedly to the hospital for reasons that might be related to the care provided during their initial hospital stay.
It represents the rate of hospital readmissions within 14 days of discharge.
Comments
NHS rate remained relatively stable in 2006-07 compared to 2005/06. The average annual rate continues to be within the mean of the provincial average.
The NHS was recognized as a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report for the 2006-07 data.
This indicator is used in the determination of a hospital being a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report. A hospital must obtain a better than average rating on 2 out of 7 indicators and no lower-than-average rating.
Nurse-Sensitive Adverse Events – Medical
Source of Data:
Hospital Report
Reporting Cycle:
Annual
Definitions:
The proportion of medical patients who experienced an adverse event after admission such as a fracture caused by a fall, or a pressure ulcer.
Comments
NHS trend declined in 2006-07. The average annual rate continues to be within the mean of the provincial average.
The NHS was recognized as a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report for the 2006-07 data.
This indicator is used in the determination of a hospital being a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report. A hospital must obtain a better than average rating on 2 out of 7 indicators and no lower-than-average rating.
Nurse-Sensitive Adverse Events – Surgical
Source of Data:
Hospital Report
Reporting Cycle:
Annual
Definitions:
The proportion of surgical patients who experienced an adverse event after admission such as a fracture caused by a fall, or a pressure ulcer.
Comments
NHS rate improved in 2006-07. Average annual rate is below the mean of the provincial average.
The NHS was recognized as a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report for the 2006-07 data.
This indicator is used in the determination of a hospital being a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report. A hospital must obtain a better than average rating on 2 out of 7 indicators and no lower-than-average rating.
Adverse Events – Labour and Delivery
Source of Data:
Hospital Report
Reporting Cycle:
Annual
Definitions:
The proportion of labour/delivery patients who experienced an adverse event after admission such as a cardiac event or a wound infection.
Comments
NHS trend declined in 2006-07. The most recent average annual rate is within the mean of the provincial average.
The NHS was recognized as a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report for the 2006-07 data.
This indicator is used in the determination of a hospital being a High Performer for the Acute Care Clinical Utilization and Outcomes quadrant of the Hospital Report. A hospital must obtain a better than average rating on 2 out of 7 indicators and no lower-than-average rating.
Chronic & Complex Care
Independent Activity
Source of Data:
Hospital Report
Reporting Cycle:
Annual
Definitions:
Independent Activity (% of Patients) looks at the percentage of patients who have demonstrated growing independence over a typical 90-day period.
A higher number means most of the hospitals' chronically ill patients are showing improvements in their ability to perform daily living activities.
Comments
NHS rate improved in 2006-07. Average annual rate continues to be within the mean of the provincial average.
New Falls
Source of Data:
Hospital Report
Reporting Cycle:
Annual
Definitions:
New Falls (% of Patients) estimates the percentage of patients without a recent history of falling who fell during a typical 90-day period.
A lower number is better since it shows a smaller percentage of patients had new falls.
Comments
NHS rate remained stable in 2006-07. Average annual rate continues to be within the mean of the provincial average.
Pressure Sores
Source of Data:
Hospital Report
Reporting Cycle:
Annual
Definitions:
Pressure Sores (% of Patients) estimates the percentage of patients in a typical 90-day period that had a pressure ulcer at any stage of development.
A pressure ulcer starts as reddened skin but gets progressively worse, forming a blister, then an open sore, and finally a crater.
A lower number is considered better since a smaller percentage of patients suffer from pressure sores.
Comments
NHS rate improved in 2006-07. The most recent average annual rate is within the mean of the provincial average.
Physical Restraint Use
Source of Data:
Hospital Report
Reporting Cycle:
Annual
Definitions:
Physical Restraints (% of Patients) estimates the percentage of patients who were physically restrained, on a daily basis, during a typical 90-day period.
A lower number is generally considered to reflect better performance.
Comments
NHS rate improved in 2006-07. The average annual rate continues to be within the mean of the provincial average.