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Measuring Up: Health Quality Ontario Releases Yearly Report

Find out the results of our yearly report: A look at the quality of care in Ontario using indicators from the Common Quality Agenda.

Our recently released report, Measuring Up is our yearly review of the health of Ontarians and our health system. It is a critical part of our mandate as the provincial advisor on quality and an innate part of supporting quality improvement work. Quality improvement relies on the feedback loop that measurement generates. Such yearly reviews allow us to measure, collectively evaluate progress, focus new improvement efforts, measure again, and assess if improvement has taken hold or whether we should try a different approach.

Measuring Up is based on the Common Quality Agenda, a set of indicators developed with experts across the province. These indicators measure a range of aspects of health system performance, from the number of nurses, family doctors and specialists across the province, to the timeliness of follow-ups after hospital discharge, to regular eye exams for adults with diabetes or the number of Ontarians who are smoking. The breadth of indicators reported on is an effort to capture the quality of care of the system as a whole.

One of the really positive findings in this year’s report is about one-third of the measurements have improved, with more Ontarians maintaining healthy lifestyles, smoking less and staying physically active.

More than half of the measurements in the report have remained unchanged, often over many years. However flat measures like these aren’t necessarily bad. For example, take the case of wait times for cancer surgeries and hip and knee replacements, where results have remained flat. Given that more people have needed these procedures over the years, these results can be viewed positively. The same might be argued for the rates of falls and pressure ulcers for Ontarians in long-term care homes. Though the rates for both have stayed about the same, we also know that there are more elderly Ontarians with more complex conditions in homes.

One of the important findings that is consistent with last year’s report is startling variation in outcomes depending on factors such as where one lives, one’s income and even one’s sex.

For example, in the North West, just over a quarter of patients received a follow-up after leaving the hospital with heart failure, while in the Central west more than half did. In another example, we saw that the rates of physical restraint use in long-term care homes differed between 3% and 14% in Toronto Central and North West regions, respectively.

It is important to try and understand these variations. There are likely many different reasons for these findings depending on the measure in question.

Also apparent in the report is Health Quality Ontario’s commitment to ensuring our work reflects the voices and experiences of patients, families and caregivers. In Measuring Up, we’ve actively engaged with patients and the public, talking to Ontarians and learning about their experiences with the health system. There’s Christa, who shared her experience with diabetic retinopathy, and Janice, who became a caregiver when her husband’s dementia progressed. These are real people that breathe life into the measurements found in our report, adding another dimension to the quality improvement work occurring throughout the province.

I’d appreciate hearing your thoughts about the report and why measurement is an important part quality improvement. Please tweet us at @HQOntario with any insights or questions so we can continue this discussion.

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