"Toronto Rehab is a high performing, dynamic, engaged organization which is focused on providing exemplary quality care to meet the needs of the patients and families it serves."
- Accreditation Canada
At Toronto Rehab we use a variety of indicators to evaluate different aspects of our performance to obtain a balanced perspective of the quality of our services. From the functional improvements our patients make and their perceptions about the care they receive, to the amount of external research funding we attract and whether students who train here would recommend Toronto Rehab to others, we track how we measure up in these and other key areas so we can identify where we are performing well and where we need to improve.
Earning accreditation a quality achievement
Toronto Rehab firmly believes in ensuring quality and value in everything we do and participation in Accreditation Canada's quality program is an important part of that philosophy. For the greater part of last year, our staff, physicians and volunteers prepared for a four-day survey visit from evaluators with Accreditation Canada, a non-government organization that measures health organization services against national quality standards.
Our visit was held the first week of May 2010 and included team interviews, onsite tours, documentation review and stakeholder discussions. Surveyors evaluated our programs and services by focusing on quality improvement, planning, risk management, medication management, infection prevention and control, emergency preparedness, client and staff safety, ethics, human capital, resource management, performance measurement and governance.
We are pleased to report that Toronto Rehab has earned accreditation with no condition through this program. The surveyors were highly complimentary of our services, teams and the organization-wide commitment to quality that every one of our staff, physicians and volunteers contributes to on a daily basis. They also recognized Toronto Rehab for seven leading practices that demonstrate innovation and creativity and that have a positive impact on services or outcomes for patients and families.
These leading practices include:
- the Stop Adverse Fall Events (SAFE) strategy;
- our Low Tolerance Long Duration rehabilitation service;
- our Balance, Falls and Mobility Clinic;
- the Fractured Hip Rapid Assessment and Treatment Program (FHRAT);
- the SCI (Spinal Cord Injury) Resource Centre;
- and our efforts to foster wellness and organizational health.
Stroke service receives national distinction
What made this Accreditation Canada survey even more important is that it included a separate review of our Stroke Rehabilitation Service, which was evaluated against new national standards in order to be considered for an Award of Distinction in stroke rehabilitation -- the first award of its kind.
The Stroke Services Distinction is awarded to health organizations that meet or exceed the best standards of stroke care. This award is the first disease-specific accreditation program in Canada and recognizes leadership, clinical excellence, and innovation in stroke care.
We are very pleased to report that Accreditation Canada, along with the Canadian Stroke Network, has awarded our Stroke Service with a Stroke Services Distinction designation, the first rehabilitation service to earn the award and the associated national acclaim as a leading stroke program in the country.
Hospital Service Accountability Agreement targets
Like all hospitals in the province, Toronto Rehab is committed to meeting the clinical and operational performance targets in our Hospital Service Accountability Agreement with our Local Health Integration Network. Our annual operating plan is developed to support the achievement of these targets, which serve an important role in ensuring that government, taxpayers and, most important, our patients are assured that the services we provide meet expectations and add value to patients' lives in the health system.
| 2009 - 10 | 2010 - 11 | |||||
|---|---|---|---|---|---|---|
| HSAA target | MOHLTC Performance Corridor | Mar 31/09 Year-end Forecast | HSAA target | MOHLTC Performance Corridor | Planned targets | |
| Total Margin | 0.00% | Cannot be below zero | 0.50% | 0.00% | Cannot be below zero | 0.00% |
| Current Ratio | 1.06 | 0.8-2.00 | 1.21 | 1.06 | 0.8-2.00 | 1.06 |
| Percentage of FT Nurses* | 70.00% | 69.00% | 73.00% | N/A | N/A | 70.00% |
| Inpatient Rehab Days | 72,420 | > 68,075 | 71,656 | 72,420 | > 68,075 | 68,089 |
| CCC Weighted Days | 78,905 (1.049 avg CMI, 92% avg occupancy) | > 72,593 | 73,268 | 78,905 (1.049 avg CMI, 92% avg occupancy) | > 72,593 | 73,268 |
| Ambulatory Care Activity (visits) | 80,000 | > 64,000 | 85,977 | 80,000 | > 64,000 | 80,117 |
| % Chronic Patients with New Stage 2 or Greater Skin Ulcers* | < 6.6 | < 9 | 3.25 | N/A | N/A | < 6.6 |
* Indicators changed from performance indicators to Monitoring indicators in 2010/11 by the TCLHIN.
Public reporting of patient safety and quality indicators
April 2009 marked an important milestone in the hospital sector, one that introduced for the first time legislation that requires hospitals to make available to the public selected quality and safety indicators. These publicly reported indicators help demonstrate accountability for the hospital sector and can help educate the public about individual hospital performance on matters such as infection prevention and control, hand hygiene compliance, surgical safety checklists and wait times, to name just a few.
While some of these may not apply to rehabilitation, the majority in fact do. We not only endorse the public reporting of performance but we see it as an important part of our quality and safety promise and our role as a leader in rehabilitation.
That's why last year we developed a comprehensive section on our website to post this information and provide detailed information about quality indicators and our performance above and beyond what is required by legislation. We are particularly proud of the response to this opportunity to openly report our performance and we look forward to ongoing opportunities to further demonstrate our accountability and transparency to our communities.
Ongoing growth in patient satisfaction
One of the most important indicators of the quality of our services is patient satisfaction. We measure patient satisfaction based on a number of factors, from the quality of the care our patients receive, to their perception of the interaction with caregivers, to the comfort of their environment. All of these are critically important elements that make up a patient's experience, one that ultimately can have an impact on patient outcomes.
Patient satisfaction in our Complex Continuing Care Program last year showed an overall significant increase over the previous year, a testament to the hard work of the staff at the E.W. Bickle Centre and the efforts underway way there to make it a more comfortable environment for patients and their families.
Our rehabilitation inpatient satisfaction rates also showed significant improvement last year. In fact, our overall satisfaction results of 96.9 per cent were well above the provincial average of 93.7 per cent. This, too, is reflective of the tireless and committed work of our people in helping patients and families maximize their lives to the fullest extent possible.
Accessibility is always top of mind
Last year marked the introduction of a new Customer Service Standard under the Accessibility for Ontarians with Disabilities Act (AODA). Toronto Rehab, an organization committed to helping people overcome the challenges of disabling injury or illness, developed new policies and procedures to comply with the standard. As well, nearly all of our employees and volunteers have completed customer service training and orientation on this new standard.
Looking Ahead
We believe in being accountable stewards of public funds and, therefore, we use our resources wisely and as efficiently as possible while ensuring the delivery of quality health services. The quality commitment we make in everything we do has positioned us well to further reinforce Toronto Rehab as a leader in rehabilitation science.
And because we take quality so seriously, the recently introduced Excellent Care for All Act, 2010, is something that we feel we're able to immediately incorporate into our operations as many of the provisions in the Act are activities we already have in place. We very much look forward to and welcome any opportunity that advances our commitment to quality and patient safety and will continue to work with our health system partners and the Toronto Central Local Health Integration Network to contribute to quality improvement throughout the entire health system.