Measuring the quality of care at the national level is no easy feat. At the Saskatoon Health Region, however, a dashboard of quality indicators is showing how it can be done.
Since 2009, as part of its Long Term Care Quality Monitoring Framework, the region's web-based monitoring tool has captured key quality and safety indicators from multiple data sources on a one-page scorecard. Performance and outcomes are highlighted in red, yellow and green, so with a single glance staff at 29 long-term care facilities can see how residents are doing and compare their home with peer facilities.
Multiple sources of data feed into the dashboard, with evidence-based quality indicators developed by interRAI, an international research collaborative, and supported for use in Canada by CIHI, playing a key role, says Vlatka Tustonic, the region's lead for strategic initiatives with Continuing Care and Seniors' Health.
"They are meaningful to our teams and help improve the quality of life for our 2,100 residents by shedding light on what we need to focus on."
The interRAI tools monitor how individual patients and nursing homes are doing, and they allow for comparisons among long-term care facilities. In the early days, the RAI data also helped the region determine meaningful things to measure.
The dashboard streamlines data collection, making it easier for front-line teams to use it in decision-making. In the past, it would take up to three weeks each quarter to collect this data. Now, electronic and user-friendly quarterly reports are generated at the push of a button.
Within seconds, staff can compare such things as their home's rate of infection, prevalence of falls and depression among residents. They can track indicators over time and have best practice information at their fingertips to help improve outcomes. They can also enter interventions and improvement plans that are designed to meet performance targets. Because everyone's data is presented, homes can learn from others who are doing well.
"It gives the entire team a good idea of what our successes are and what we need to get better at," says Lynn Kohle, an administrator with Lakeview Pioneer Lodge.
Dashboard data is real-time and web-accessible, eliminating reliance on historical data.
"We need to know where we're at today so we can intervene in a timely manner," Tustonic says. "Now, when it's uploaded, data is there. When comments and quality improvement plans are entered, they're there."
Progress is also immediately apparent, which is rewarding and motivating.
"We've seen changes where some sites were in red in several key areas and now they're consistently green. They're taking pride in the fact that they have worked hard and improved their performance."
Deemed a leading practice in benchmarking, transparency, and quality and safety, the long-term care dashboard has been adopted by the province's Health Quality Council to measure and benchmark the Saskatchewan Surgical Initiative. The region and Ministry of Health are also looking at how to adopt it further across the province.
It's also attracted the attention of those working at the national level, who had previously thought it would take a decade to reach this point in quality and outcome measurement.
"This is a practical example of one way to measure quality and performance," Tustonic says. "It's a precursor of where we want to be nationally."
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