Ambulatory care is an essential and growing component of hospital care and as such, interest in accountability and performance measurement within the area of hospital-based ambulatory care is growing. In previous Hospital Reports, Emergency Department Care and Day Surgery were reported but this year, the development of indicators in the more general area of ambulatory care was proposed in response to feedback from stakeholders at successive Hospital Report regional information sessions.
The nature and scope of ambulatory care clinic services vary considerably from hospital to hospital on account of variations in perceived patient and community needs and the extent to which various types of clinics located throughout a hospital are classified as ambulatory care. Accordingly, identifying and prioritizing ambulatory care performance indicators relevant to most or all Ontario hospitals was challenging. The research team tried to address this challenge by consulting with hospital managers in Ontario to develop and narrow the definition and scope of the investigation. Additionally, with the use of advisory panels, we identified indicators in all four quadrants using established Hospital Report processes. Although only three indicators are reported within the Acute Care 2006 report in two quadrants (system integration and change and clinical utilization and outcomes), this report focuses on the development process, the reasons for reporting only a few indicators, and considerations for future reporting initiatives.
In total, 109 acute care hospitals completed the survey, with data collected in January 2006; all of the 14 LHINs and the 3 peer groups (i.e., small, community and large hospitals, as designated by the 2005 Joint Policy and Planning formula) are represented.
Jillian Paul, Neil Seeman, Anna Gagliardi, Shevani Mahindra, Paula Blackstien-Hirsch, Adalsteinn D. Brown, Carey Levinton, Jeanie Lacroix, Linda Choy, Marc Tallentire