All governments recognize the need to make home care more available and mental health care more accessible. In late 2017, the federal, provincial and territorial (FPT) governments reached a 10-year agreement that will lead to an $11 billion federal investment. This investment will go toward improving access to mental health and addiction services, and to home and community care. By endorsing A Common Statement of Principles on Shared Health Priorities, FPT governments committed to working together to ensure that health care systems continue to respond to the evolving needs of Canadians.
CIHI was asked to work with the FPT governments to select and develop a set of pan-Canadian indicators that focus on measuring access to mental health and addiction services and to home and community care.
To ensure the process is collaborative, transparent and reflects the knowledge of the sectors and needs of Canadians, CIHI is working with 2 established work groups, subject matter experts and the public to identify the indicators that will best measure access to services in these priority sectors.
CIHI published an interim progress report in March 2018, and starting in 2019, CIHI will report annually to the FPT governments and the public on the selected indicators that are supported by available data.
Progress report (March 2018)
Selecting Pan-Canadian Indicators for Access to Mental Health and Addiction Services, and to Home and Community Care: Progress Report explains the indicator selection process, provides the status of the work completed to date and outlines the current state of performance measurement in these 2 sectors. In addition to identifying the state of information standards, infrastructure and measurement in mental health and addiction services and home and community care across Canada, the progress report also outlines how sector stakeholders, measurement experts and the public were engaged to provide advice on where to focus measurement. FPT government representatives will use this information as they work toward selecting meaningful indicators to measure pan-Canadian progress on improving access to mental health and addiction services, and to home and community care.
CIHI has long-standing programs of work that measure the performance of health systems. Given CIHI's experience, the organization is well-positioned to facilitate the selection and development of new and existing indicators to track progress on the FPT health ministers' commitments. This work aligns with CIHI's mandate to deliver meaningful, comparable information that will accelerate improvement in health care, the performance of health systems and the overall health of the population. The focus on mental health and addiction, and on home care and community care also aligns with CIHI's strategic plan.
CIHI-FPT work groups
2 CIHI-FPT work groups were established for this project — 1 for each priority sector (mental health and addiction, and home and community care).
They are made up of 1 representative appointed by each federal, provincial and territorial ministry of health and 1 representative each from CIHI and Health Canada. Quebec has observer status, to share information and best practices. The work groups' task is to consider and make final recommendations on a set of 3 to 5 common indicators of access for each of mental health and addiction services, and home and community care.
For details, see the list of work group participants and the terms of reference.
Process and timeline for selecting common indicators
This diagram illustrates the indicator selection process.
The indicator selection process and activities of the Shared Health Priorities work are divided into 6 steps.
Steps 1 through 3 took place between October 2017 and February 2018.
Step 1 involved scans and assessments, validated by federal/provincial/territorial work groups. They assessed the state of services, measures, and information standards and systems. The CIHI and federal/provincial/territorial work groups reviewed and validated the information.
Step 2 involved engagement with federal/provincial/territorial governments, stakeholders and the public. CIHI engaged with federal/provincial/territorial governments, sector stakeholders, measurement experts, patients and the public. CIHI gathered information on priorities to set principles that will guide indicator selection.
Step 3 involved discussion and assessment of indicators. The CIHI and federal/provincial/territorial work groups prioritized existing measures that could be used to measure access to mental health and addiction and home and community care services. They identified information gaps where new measures are required.
Steps 4 and 5 are expected to take place between March and June 2018.
Step 4 will involve the proposal of indicators. The CIHI and federal/provincial/territorial work groups will select a common set of 3 to 5 indicators for mental health and addiction and home and community care services.
Step 5 will involve making indicator recommendations. The federal/provincial/territorial Conference of Deputy Ministers of Health and health ministers will receive indicator recommendations.
Step 6 is expected to start in late 2018 or early 2019.
This final step will involve indicator development and ongoing reporting. This will include defining the methodology for all indicators and developing data sources for new indicators. There will be annual reporting to Canadians.
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