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Measuring harm 

How safe are hospitals in Canada? CIHI partnered with the Canadian Patient Safety Institute (CPSI) to help answer this question.

Representatives from both organizations — Tracy Johnson, director of Health System Analysis and Emerging Issues, and Kira Leeb, director of Health System Performance at CIHI, and Sandi Kossey, senior director of Strategic Partnerships & Priorities at CPSI — sat down to talk to us about their collaborative work. 

With CPSI’s mandate of safer health care in Canada, we were pleased to partner with CIHI on this important work to drive real improvements. Our complementary roles added to the strength and credibility of the partnership. It was a natural match.

Sandi Kossey, CPSI

What’s changing?

Until now, there has been no single big-dot measure that provides a broad perspective on patient safety in Canadian hospitals. It made sense to combine CIHI’s measurement expertise with CPSI’s commitment to drive improvements in safety. We also involved patient safety experts from across Canada to advise us on what to include in the measures. Our collaboration resulted in a measure that includes 31 different types of events that are deemed to be preventable by clinicians.

There is a lot of focus on the topic of health care teams working hard to keep patients safe. Our efforts are concentrated on providing good data and information to help those working in and managing hospital care understand where care might be improved.

Tracy Johnson, CIHI

Tell us about the report.

Measuring Patient Harm in Canadian Hospitals (PDF) was intentionally launched during Canadian Patient Safety Week in October 2016. The report introduces a new measure intended to monitor variations in patient safety in acute care settings and provides an overview of where things are at in Canada (outside of Quebec). In addition, CPSI developed the accompanying Hospital Harm Improvement Resource, which features evidence-informed practices. It provides general patient safety information as well as quality improvement resources, tips on how to use the measure and resources specific to each of the 31 harmful events.

What’s a big-dot approach?

Normally we develop single condition–specific indicators that are focused on 1 area of care such as surgical site infections. In this case, we looked at 31 different types of harmful events (e.g., infections, falls, pressure ulcers) all rolled up into 1 number measuring how many patients experienced at least one harmful event during their hospital stay.

Are patients involved?

Absolutely. It was important to have patients and families contribute their valuable perspectives to this work, including members of Patients for Patient Safety Canada who had directly experienced harm. We wanted them to see themselves in the data and help shape the report.

While it may not be possible to prevent every single occurrence of harm, this collaboration will help. The joint approach of measuring the occurrence of these events using data and providing focused support and resources will be useful as we track and monitor improvement efforts.

Kira Leeb, CIHI