Halifax, NS Today AIMS took a giant step in empowering the patients who use our hospitals and their families who are trying to ensure that their loved ones get the care that they need. The Institute released the first paper in a major new project that aims to create the best tool in Canada today for assessing the quality of care offered by the country’s major hospitals.

The paper, entitled A FINGER ON THE PULSE: Comparative Models for Reporting the Quality of Hospital Care takes on many of the myths that surround the idea of comparing the quality of care in our hospitals. According to author Julia Witt, “Consumers need to be able to compare the quality of different products and services if they are to make an informed choice. That is true whether it is the gas mileage of different models of cars or the quality of health care provided by different hospitals.”

Witt, AIMS Fellow in Pharmaceutical Policy, looked at the American, European, and Canadian experience with accreditation mechanisms and quality assessment systems in health care.

This is the first background paper in AIMS’ Hospital Report Card project, which is designed to evaluate the performance of Canada’s major hospitals. As Witt points out in this first paper, the information required to evaluate many aspects of health care delivery is lacking, yet evaluations can be made by making best use of all the information that is available.

According to Witt’s paper, problems exist in Canadian hospitals with the quality and usefulness of available information and the lack of standardized measures. It also suggests there is a sense that hospitals all too often attempt to manipulate the numbers in order to look better in comparative rankings rather than make genuine changes that may improve patient outcomes. The paper concludes there is an overall lack of understanding about many accreditation and quality measurement issues in the nation’s hospitals.

In Canada, some progress was made with the implementation by the Canadian Institute of Health Information (CIHI) of a set of 14 quality measures in the areas of health status, health outcomes, and quality of health care services, but Witt says that process is flawed.

“The Auditor General of Canada and several provincial auditors general have noted their inability to comment on the quality of information generated by CIHI, due to inadequacy in the quality assurance processes that ensure the data are accurate, a lack of data standards and a lack of data definition for certain indicators,” explains Witt.

The paper goes on to note that although a tremendous amount of information is produced, the usefulness of much of it for patients is at best questionable. The outcomes of these studies are oriented toward management and are often geared toward efficiency issues that result in cost savings. Therefore such studies are not necessarily aimed toward better outcomes for patients. The second paper in this series will outline the framework of the AIMS Hospital Report Card and a process to better use existing information to provide a more accurate picture of the quality of hospital care.

“Reporting on the quality of care that patients receive in Canadian hospitals is the responsibility of governments, hospital boards, and professional accreditation agencies,” notes Witt. “Accreditation and quality measurement of hospitals and health systems are controversial issues, but the demand for such measurement is growing. The addition of the AIMS series on Hospital Report Cards will hopefully meet this demand with accurate and easily understood measures.

“What we are looking to accomplish in this series is to provide policy makers and Canadians with the straight facts on the performance of Canadian hospitals and present alternatives for the future,” explained AIMS President Brian Lee Crowley. “Julia Witt’s paper is the first step. It lays out the challenges that need to be overcome, in Canada, in any attempt at measuring how well our hospitals serve their patients.

“Systems exist elsewhere that Canadians must be aware of in order to understand the role of health information and accreditation. Patients have the right to know which hospitals are performing properly and which ones require improvements. Our Hospital Report Card, which is now in preparation, aims to do just that,” added Crowley.


For further information:

Julia Witt, AIMS Fellow in Pharmaceutical Policy, 519-763-7496

Jamie MacNeil, AIMS Manager of Health Policy, 902-446-3532

Brian Lee Crowley, President of AIMS, 902-499-1998