by David Shipley
An Atlantic Canadian think tank is developing annual report cards on the quality of care at New Brunswick hospitals it says governments are reluctant to provide.
Unlike information on the safety of restaurants, which is easily accessible at the Department of Health website, information on the safety and quality of care at hospitals throughout New Brunswick is difficult to find and understand.
Charles Cirtwill, acting president of the Atlantic Institute for Market Studies, or AIMS, says it’s not surprising that information on the quality of care at hospitals is difficult to find.
“Governments don’t run restaurants so it is easy for them to hold restaurants to account because they’re not the ones who are going to have to make the changes to adjust,” he said.
“The situation we have in health care, remember, is that the government pays, the government provides and the government regulates. As long as they’re doing all three of those jobs, we are never going to get a situation where we have the kind of open reporting and effective measurements and accountability that we have in other industries.”
That lack of accountability is something AIMS is hoping to correct with the hospital report cards.
The new report cards will focus on the quality of care patients receive at hospitals throughout the Atlantic provinces.
“Our objective within five years is to have a report card that is reasonably comprehensive,” Cirtwill said.
Using the report card, patients will be able to determine if they feel safe going to particular hospital. Patients will also be able to determine which hospital is best suited to treat their particular malady, said Cirtwill.
The Halifax-based think tank has experience with report cards on government services.
For the last five years AIMS has been fine tuning its high school scorecard, which compares the performance of schools throughout Atlantic Canada.
Cirtwill said while AIMS has gained experience with grading high schools, measuring hospital performance and patient outcomes from hospital care remains a daunting task.
Measuring whether hospitals offer quality care depends on finding not only the right indicators to measure their performance with statistics, but also taking into account widely varying patient circumstances that can play a role in whether people recover during a hospital visit.
Cirtwill said AIMS hopes to use indicators of quality care and hospital efficiency currently measured by organizations such as the Canadian Institute for Health Information (CIHI), as well as the different regional hospital authorities and the provincial government.
“This information is being collected, sometimes it’s reported publicly, most times it’s not being reported publicly. That’ll be part of our exercise, forcing more and more of this information into the public domain.”
As well as using existing information, AIMS will look to use new indicators on patient outcomes not currently collected by CIHI or the government.
Those indicators include the percentage of patients with appropriate wait times and whether patients have increased function, life expectancy or comfort as a result of hospital care.
Lise Daigle, executive director of hospital services for the Department of Health, said caution must be used when deciding which indicators of hospital efficiency or quality of care should be used.
“Measuring safety or measuring quality in health care is a much more complicated thing than what one would think at first,” she said.
Daigle said the Department of Health’s 2002 New Brunswick Hospital System Performance Measurement Initiative taught the department the importance of balancing indicators.
“You have to look at indicators of efficiency. You have to look at indicators of satisfaction, of system integration and preparation for the future.”
Daigle said she’s couldn’t say when the province’s five-year-old hospital scorecard would be updated. However, the department continues to use its findings to improve services such as adding additional cardiac catherization labs to hospitals in the province.
“We do want to keep New Brunswickers informed. We have many, many initiatives to do that,” she said. “Like what we currently have for wait times for surgery; if you go to our website you start to see some results.”
Part of the reason more information on the quality of New Brunswick care isn’t easily accessible is that such information is difficult for the department to collect, said Daigle.
“We don’t always have all the information at our fingertips or it’s not always computerized. So collection of those things is not always as simple as we like.”
“That’s one of the reasons we will be investing a lot in the electronic health record. Part of that is to give better care to patients, but (e-health) will also help us collect information that it’s not easily collected right now,” he said.