Health Equity at UHN Our Quality Journey Jan
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Health Equity at UHN: Our Quality Journey Jan Lackstrom Chair, Health Equity Council Senior Clinical Director
Moving from theory to practice: Key enablers • UHN Board of Directors – Annual report to the Quality Committee of the Board – Each program to choose on quality indicator to report on • Values and Business case • Health Equity Council – Sr. Vice President accountability – Annual report to the UHN Quality Committee – Support programs in developing indicators 2
Key Supports • Performance Measurement Department – Leadership – Dedicated staff including a biostatistician – Purchased improved level of postal code data • Operational Vice-Presidents and Directors • Who knew? – Secret champions came from everywhere • Chair of Woman’s Health • Line staff, Collaborative Academic Practice, Physicians, Human Resources • Corporate Planning 3
UHN Indicators • Inclusion of health equity indicators in program based quality reports – 16 programs have reported – Themes include: • • • Wait times Readmissions Cancellation rates Patient satisfaction Access to care 4
BSC Caring Dimension Analysis Statistically Significant Findings FY 09 -10 Indicator Measures Age Sex Lang FY 11 -12 Income Age Sex Lang FY 12 -13 Income Age Hospital Standardized Mortality Ratio (HSMR) Infection of Clostridium Difficile (C. Diff) Central Line Infections ED LOS for Admitted Patients P 4 R target 90 th percentile Surgeries (Avoidable) Cancelled Within 48 Hours - significant with p-value < 0. 05; - highly significant with p-value < 0. 01; 5 - not significant Sex Lang Income
Health Equity FY 13 -14 Program Based Health Equity Indicators Statistically Significant Findings Program/Service Indicator Measures Age Sex Language Income Date of BQ Presentation KNC Inpatient 30 -Day Readmissions Mar 31, 2014 Infection Prevention and Control MRSA Screening Collected Within 6 Hours of Admission Mar 31, 2014 1) Access to Evaluation Transplant 2) Access to Listing Feb 24, 2014 3) Access to Transplant MCC – CMH (Psychiatry) 1) Restraint Used in PESU Feb 24, 2014 2) Restraint Used in Inpatient Units - significant with p-value < 0. 05; - access; - highly significant with p-value < 0. 01; - wait time - outcome; 6 - not significant
