CIHI is supporting the performance measurement commitments made by the health ministers in the Common Statement of Principles on Shared Health Priorities. We are working closely with federal, provincial and territorial (FPT) governments to develop a set of common indicators focused on measuring pan-Canadian access to mental health and addictions services and to home and community care. 

FPT health ministers endorse pan-Canadian indicators of access (June 2018)

In June, the FPT health ministers* endorsed a set of indicators for measuring access to mental health and addictions services and to home and community care  that was recommended by CIHI, on behalf of the CIHI-FPT work groups. These recommended indicators were informed by the advice of sector stakeholders, measurement experts and the public, and by published literature on the subject.

The endorsement of these sets of common indicators of access to mental health and addictions services and to home and community care marks a significant step toward improving access to services and support in sectors that are clearly important to Canadians. Over the next 10 years, CIHI will work with FPT governments to report annually to the Canadian public on these indicators.

Important work remains to be done before CIHI can report reliable and comparable indicators on behalf of the provinces and territories. As we continue these efforts, the names of the endorsed indicators may change as the indicator definitions and methodologies are refined.

Recommended indicators for access to mental health and addictions services:

  • Wait Times for Community Mental Health Services, Referral/Self-Referral to Services (services provided outside of emergency departments, hospital inpatient programs and psychiatric hospitals)
  • Early Identification for Early Intervention in Youth Age 10 to 25 (to be defined)
  • Awareness and/or Successful Navigation of Mental Health and Addictions Services (self-reported, to be defined)
  • Rates of Repeat Emergency Department and/or Urgent Care Centre Visits for a Mental Health or Addiction Issue
  • Hospitalization Rates for Problematic Substance Use
  • Rates of Self-Injury, Including Suicide

Recommended indicators for access to home and community care:

  • Wait Times for Home Care Services, Referral to Services
  • Alternate Level of Care Length of Stay for Inpatients Requiring Home Care Services
  • Home Care Services Helped the Recipient Stay at Home (self-reported)
  • Caregiver Distress
  • (In)appropriate Move to Long-Term Care
  • Death at Home/Not in Hospital (to be defined)

In 2019, CIHI will begin annual reporting for the selected indicators where data is currently available. Where required, CIHI will continue to work with FPT governments to define the methodology for indicator calculation and to identify new data sources to enable comparable reporting.

*The federal government has agreed to an asymmetrical arrangement with Quebec, distinct from the Common Statement of Principles.  In addition, given the transition to a new government in Ontario, the province cannot officially endorse the recommendations.

Shared Health Priorities background

All governments recognize the need to make home care more available and mental health care more accessible. In late 2017, the 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 addictions 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 addictions services and to home and community care.

CIHI’s role

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 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 addictions and on home and community care also aligns with CIHI’s strategic plan.

CIHI-FPT work groups

2 CIHI-FPT work groups were established to consider and recommend to FPT health ministers 2 focused sets of common indicators of access: 1 for mental health and addictions services, and 1 for home and community care.

The CIHI-FPT work groups were made up of 1 representative appointed by each federal, provincial and territorial deputy minister of health and 1 representative each from CIHI. Quebec has observer status, to share information and best practices. Members received the advice of sector stakeholders, measurement experts and the public to support their decisions and recommendations.

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 addictions 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 addictions services, and to home and community care.

Process and timeline for selecting common indicators

This diagram illustrates the indicator selection process.

Process and timeline for selecting common indicatorsProcess and timeline for selecting common indicatorsProcess and timeline for selecting common indicators

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 addictions and home and community care services. They identified information gaps where new measures are required.

Steps 4 and 5 took place between March and June 2018.

Step 4 involved the proposal of indicators. The CIHI-FPT work groups selected a common set of 3 to 5 indicators for mental health and addictions and home and community care services.

Step 5 involved making indicator recommendations. The FPT Conference of Deputy Ministers of Health and the health ministers received 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. Annual reporting to Canadians will start in 2019 for the selected indicators that are defined and have existing supporting data. More indicators will be added yearly as they become available for different provinces and territories.

If you have any questions or would like more information on this program, please email help@cihi.ca.