R E H A B I L I T A T I O N - Ontario Hospital Association

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A BALANCED SCORECARDWHAT IS ABALANCED SCORECARD?Providing care in a health care facility is a complexactivity involving a multitude of skills, experiencesand technologies. No single aspect of the systemcauses poor or excellent hospital performance. Forthis reason, performance-measurement activities mustinclude measures that provide insights into multipledimensions of a hospital’s performance. The balancedscorecard approach describes performance across fourdimensions or quadrants critical to the strategic successof any health care organization. These quadrantsinclude: System Integration and Change, ClientPerspectives, Clinical Utilization and Outcomesand Financial Performance and Condition.Performance measures for each of the four quadrantsare provided at the hospital-specific level, along withaverage scores by LHIN and the province as a whole.While all hospitals’ values are used in calculatingaverage results by LHIN and the province, hospitalspecificvalues are shown for hospitals that hadsufficient data and agreed to have their resultspublished for quality improvement purposes. Thisyear, 57 out of 58 (98%) hospitals with designatedrehabilitation beds participated in at least onequadrant and 37 (64%) hospitals participatedin all four quadrants of the report.Using a balanced scorecard format, this report providesa summary of performance scores for 23 indicatorsacross four areas of performance.System Integration and ChangeSYSTEM INTEGRATION AND CHANGEThis quadrant focuses on indicators that assess efforts and investments that hospitalsneed to make in order to improve the delivery of adult inpatient rehabilitation services.It measures the extent to which best practices and the involvement of different players arenecessary for making decisions about care, and implementing a client-centred approachto service delivery. [9 indicators]Client PerspectivesCLIENT PERSPECTIVESThis quadrant describes clients’ perceptions of the care they received during inpatientrehabilitation. For participating hospitals, surveys were mailed to clients following theirdischarge from hospital asking them to rate the care they received related to severalcomponents of client-centred rehabilitation, including participation in decision-making andgoal-setting, evaluation of outcomes from the client’s perspective and family involvementin care. [8 indicators]Clinical Utilization and OutcomesCLINICAL UTILIZATION AND OUTCOMESThis quadrant presents indicators that evaluate hospitals’ clinical performance for clientsthat are cared for in designated adult inpatient rehabilitation beds. The indicators, fromthe National Rehabilitation Reporting System, describe changes in the Total FunctionScore i as measured by the FIM TM instrument, length of stay and length of stay efficiency.Indicators are reported for the following Rehabilitation Client Groups (RCGs) ii : All RCGs,Stroke and Orthopedic Conditions. [3 indicators]Financial Performance and ConditionFINANCIAL PERFORMANCE AND CONDITIONThis quadrant describes selected measures of efficiency and productivity in hospitals withdesignated rehabilitation beds. [3 indicators]i. Total Function Score referenced in this document is based on data collected using the FIM TM instrument.The 18-item FIM TM instrument referenced herein is the property of Uniform Data System for MedicalRehabilitation, a division of UB Foundation Activities, Inc.ii.Each of the three indicators are reported for the following Rehabilitation Client Groups (RCGs): All RCGs, Strokeand Orthopedic Conditions. Rehabilitation Client Groups (RCGs) adapted with permission from the UDSMRimpairment codes. Copyright 1997 Uniform Data System for Medical Rehabilitation, a division of UB FoundationActivities, Inc., all rights reserved. PAGE 4
“HIGH-PERFORMING” HOSPITALSHIGH-PERFORMING HOSPITALS WITHIN QUADRANTSSystem Integration and ChangeSYSTEM INTEGRATION AND CHANGECriteriaHighest score (or 100) on one indicatorand above-average rating for at least 4 of 9indicators and no below-average rating.High Performing Hospitals- The Credit Valley HospitalClient PerspectivesCLIENT PERSPECTIVESCriteriaAbove average on 6 of 8 indicators and nobelow-average score on any indicator.High Performing Hospitals- Providence Continuing Care Centre- Sisters of Charity of Ottawa (SCO)Health Service- St. Joseph’s Health Care London- The Ottawa Hospital- West Park Healthcare CentreClinical Utilization and OutcomesCLINICAL UTILIZATION AND OUTCOMESCriteriaAbove-average rating on Total FunctionChange, average or above-average ratingon Average Active Rehabilitation Length ofStay and average or above-average ratingon Length of Stay Efficiency for at least oneof the following RCGs: All RCGs, Stroke,Orthopedic Conditions or the sub-categorieswithin Orthopedic Conditions, Post HipFracture or Post Hip and Knee Replacement.High Performing Hospitals- Hôtel-Dieu Grace Hospital- Humber River Regional Hospital- Joseph Brant Memorial Hospital- Pembroke Regional Hospital- St. John’s Rehab Hospital- St. Mary’s General Hospital- The Credit Valley Hospital- Trillium Health CentreFinancial Performance and ConditionFINANCIAL PERFORMANCE AND CONDITIONCriteriaThere are no high-performing criteria for theFinancial Performance and Condition quadrant.For quality improvement purposes, theHospital Report series has developedmethodologies to identify “highperforming”hospitals within three ofthe quadrants in rehabilitation care.It is useful to highlight hospitals thatperformed well in particular quadrantswhen compared to their peers, becausethese hospitals may be able to shareuseful ideas and best practices with otherhospitals within the specific areas of focus.It is interesting to note that no hospitalswere identified as high performing acrossall three quadrants. This illustrates theimportance of using a variety of measures,such as a balanced scorecard approach,when looking at hospital performance.Good performance in one quadrant doesnot necessarily translate into goodperformance in another quadrant.In addition, high performance in a givenyear relates only to how hospitals performbased on the indicators calculated for thatparticular year. High performance is notnecessarily a predictor of high-performingstatus in future years.High-performing hospitals are listedin alphabetical order.PAGE 5
Page 1: HospitalReportR E H A B I L I T A T
Page 5 and 6: A SNAPSHOT OF HOSPITAL ACTIVITYIN O
Page 7: Table 2 depicts the total number of
Page 11 and 12: INTERPRETATION OF BOX PLOTS AND PER
Page 13 and 14: SYSTEM INTEGRATION AND CHANGEINTEGR
Page 15 and 16: SUMMARY OF RESULTS (CONT’D)SYSTEM
Page 17 and 18: SUMMARY OF RESULTS (CONT’D)SYSTEM
Page 19 and 20: PERFORMANCE ALLOCATION TABLEThe per
Page 21 and 22: SYSTEM INTEGRATION AND CHANGECommun
Page 23 and 24: CLIENT PERSPECTIVESPERSPECTIVESThis
Page 25 and 26: SUMMARY OF RESULTS (CONT’D)CLIENT
Page 28 and 29: CLIENT PERSPECTIVESCommunityHospita
Page 30 and 31: CLINICAL UTILIZATION AND OUTCOMESUT
Page 32 and 33: SUMMARY OF RESULTSAll RCGsHospital-
Page 34 and 35: SUMMARY OF RESULTS (CONT’D)CLINIC
Page 36 and 37: SUMMARY OF RESULTS (CONT’D)CLINIC
Page 38 and 39: 8CLINICAL UTILIZATION AND OUTCOMESP
Page 40 and 41: FINANCIAL PERFORMANCE AND CONDITION
Page 42 and 43: SUMMARY OF RESULTSFINANCIAL PERFORM
Page 44 and 45: FINANCIAL PERFORMANCE AND CONDITION
Page 46: APPENDIX A: DATA SOURCESThe followi
Page 49: To download a copy of Hospital Repo

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