Background on the National Rehabilitation Reporting System
CIHI has been promoting health information standards for hospital-based inpatient rehabilitation services since 1995, when we initiated a national pilot study to develop and evaluate indicators, a minimum data set and a related case-mix grouping methodology.
NRS pilot study and prototype
The National Rehabilitation Reporting System (NRS) pilot study involved more than 2,000 adult rehabilitation clients and collected information on the characteristics and effectiveness of rehabilitation services in six provinces. A national prototype reporting system for inpatient rehabilitation services was implemented in April 2000, based on the results of the pilot study. The first data was submitted to CIHI in December 2000.
NRS minimum data set
The NRS minimum data set contains clinical data on functional status based on the 18-item FIM® instrument and additional cognitive elements. Socio-demographic, administrative and health characteristics information is also collected for each rehabilitation client. Facilities collect client data on admission and discharge from the inpatient rehabilitation program and send the data directly to CIHI on a quarterly basis to be included in comparative reports.
There is an option to collect additional information in a follow-up assessment, conducted between three and six months after a client completes a rehabilitation stay. Collecting this information provides an opportunity to assess sustainability of functional outcomes gained during rehabilitation.
NRS data is released quarterly in secure online eReporting for participating facilities and other authorized users. These reports are available eight weeks after the end of the fiscal quarter. These rehabilitation reports and indicators provide facilities with information to assess changes in and maintenance of client outcomes, to examine access to inpatient rehabilitation and to evaluate programs and services.
Sample indicators include
- Average Admission/Discharge Function Scores
- Average Length of Stay by Rehabilitation Client Group
- Average Days Waiting for Admission/Discharge to/From Rehabilitation
The focus is on adult rehabilitation clients who have a time-limited episode of service, individualized and documented rehabilitation plans, predicted discharge dates and expected improvements in functional status. There are 17 Rehabilitation Client Groups (RCGs), which include those with impairments, activity limitations and/or participation restrictions associated with various types of conditions:
- Brain Dysfunction
- Neurological Conditions
- Spinal Cord Dysfunction
- Amputation of Limb
- Pain Syndromes
- Orthopedic Conditions
- Cardiac Conditions
- Pulmonary Conditions
- Congenital Deformities
- Other Disabling Impairments
- Major Multiple Trauma
- Developmental Disabilities
- Medically Complex
At this time, the NRS data set is primarily targeted at adult clients (age 18 and older). The rehabilitation services are provided either in specialized rehabilitation facilities or in general hospitals with rehabilitation units, programs or designated rehabilitation beds. Clients reported in the NRS include those with a primary health condition that is physical in nature. The term “rehabilitation” in the context of NRS reporting does not included people receiving rehabilitation for a mental health condition or for drug or alcohol addiction.
Rehabilitation Client Groups (RCGs) adapted with permission from UDSMR impairment codes. Copyright © 1997 Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc., all rights reserved.