TORONTO, June 28, 2012 /Canada NewsWire/ - Quality Monitor, Health Quality Ontario's (HQO's) annual report, found a number of improvements in Ontario's healthcare system last year, including decreases in wait times for emergency department (ED) visits, MRI and CT. There have also been improvements in hand hygiene and decreases in ICU infections, as well as decreases in complications from diabetes and mortality rates for many conditions.
Numerous challenges remain, however. For chronic diseases such as congestive heart failure and chronic obstructive pulmonary disease, for example, one in five people is readmitted to hospital within 30 days of discharge. This is often the result of poor coordination at discharge. Many patients are not getting the information they need when leaving the hospital or ED. The report revealed that only six in ten patients know whom to call if they need help once they go home. About half of hospital patients don't know when to resume normal activities and only 59% of patients know what danger signs to look out for at home. These figures are worse for those discharged from emergency departments.
"Issues with transitions in care are adding to the burden already being placed on the system by fiscal pressures and an aging population," says Dr. Ben Chan, President and CEO, HQO. "There are many encouraging signs that the system is improving, but there is also no doubt that we must accelerate the pace of change if the system is to be sustainable."
Broadly speaking the report identified three system areas that are required to improve the quality of Ontario's healthcare system: chronic disease management, wait times and hospital safety. Below are some highlights of the key findings within those areas.
Chronic disease management and avoidable hospitalizations:
...The management of chronic diseases has improved slightly. Complications of diabetes, such as heart attacks, strokes, amputations and kidney failure, are on the decline. The use of recommended medications to further reduce these complications is rising. The mortality rate from strokes and heart attacks is also decreasing.
...The length of stay for ED patients has decreased slightly over the past three years by about half an hour, but is still too high. High complexity patients are spending on average 11.5 hours in the ED, compared to a provincial target of eight hours.
...Waits for CT scans are half of what they were three years ago and for 90% of people getting a CT scan, the wait is less than four weeks. There has been a major reduction of 25% in waits for MRIs over the past year.
...Long-term care wait times have stopped increasing over the past two years, but are still too long at close to four months. Hospital Safety
...Ontario has made some progress in reducing some hospital-acquired infections. There have been steady decreases in both ventilator-associated pneumonia (VAP) and central line infection (CLI) rates, which occur mostly in intensive care units.
...Hand hygiene compliance before patient contact in hospitals has improved, going from 53% in 2008 to 72% in 2011.
This year's report also contained detailed descriptions of gaps in quality, hundreds of ideas on how to improve care and success stories from across the province. For example, Northumberland Hills Hospital in Cobourg decreased monthly acute care ALC from 36% to 5%. The hospital closed 16 acute ALC beds and seven complex continuing care beds and opened a 16-bed restorative care unit, where seniors who were too frail to go after discharge could go to receive more intensive therapy so that they could be discharged back home.
"There are lots of examples of success stories in Ontario where organizations have improved coordination, adopted best practices and reduced waste in the process," says Dr. Chan. "This is an opportunity for CEOs and Board Chairs around the province to ask themselves 'If someone else has figured out a better way of delivering care, why can't I do the same?"
Health Quality Ontario (HQO) is a partner and leader in transforming Ontario's healthcare system so that it can deliver a better experience of care and better outcomes for Ontarians, and better value for money. HQO was formed through the consolidation of some of the top healthcare quality improvement organizations in the province. HQO's legislated mandate under the Excellent Care for All Act, 2010 is to evaluate the effectiveness of new healthcare technologies and services, report to the public on the quality of the healthcare system, support quality improvement activities and make evidence-based recommendations on healthcare funding. HQO is an arms-length agency of the Ontario government. Visit www.hqontario.ca for more information.