Jan-14 Updates Ministry of Health and Long-Term Care Orthopaedic Quality Scorecard Primary Hip Knee Replacement, Q2 2013/14 Key findings: The Q2 2013/14 Orthopedic Quality Scorecard (OQS) is a joint project by the Implementation Branch and Health Analytics Branch. The analyses contained in this report are made to reflect the recommendations of the Orthopaedic Expert Panel at Health Quality Ontario regarding patient cohort selection. Patient cohorts were developed for the implementation of the Quality Based Procedures and as such are used in calculating the indicators in this report. Providers may use the information to track improvements against the implemenation of recommended best-practice in the care of these patients. As legislated in Ontario’s Excellent Care for All Act, Health Quality Ontario’s mandate includes the provision of objective, evidence-informed advice about opportunities to improve quality and efficiency in the health care system. As part of its Quality-Based Funding initiative, Health Quality Ontario works with multidisciplinary expert panels (composed of leading clinicians, scientists, and administrators) to develop evidence-based practice recommendations and define episodes of care for selected disease areas or procedures. For more information on Health Quality Ontario’s Quality-Based Funding initiative, visit www.hqontario.ca. This report has been updated from previous reports to present data for the hip replacement and knee replacement patient cohorts separately. The data presented in this way provides more detailed information for tracking improvements against each of these types of patients. The main difference in the patient cohort as defined for this report compared to those previously reported from Cancer Care Ontario (CCO) is that bilateral replacements are now included . Patients undergoing bilateral surgeries comprised 1.5% of all primary hip knee replacements in FY 2011/12 and had average and median lengths of stay greater than their unilateral replacement counterparts (approximately 1 to 1.5 days longer on average). As noted above, all indicators are presented on separate tabs for the hip and the knee patient cohorts. Due to these changes the report does not include trending graphs or tables. Trending information will be presented as more data become available using the new cohorts. Provincial Level The proportion of patients discharged 'Home' is 89% for hip and 92% for knee replacements. The proportion of patients discharged home meeting the 4.4 day target length of stay is 88% for hip and 90% for knee replacements. The 90th percentile for the target of 7 day length of stay is met for both hip and knee replacements, with 98% of patients in each group with hospital stay completed within 7 days. Wait times for both hip and knee replacements are above the targeted 182 days, being 190 days for hip and 225 days for knee replacements. Changes from reports by CancerCare Ontario
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Jan-14
Updates
Ministry of Health and Long-Term CareOrthopaedic Quality ScorecardPrimary Hip Knee Replacement, Q2 2013/14
Key findings:
The Q2 2013/14 Orthopedic Quality Scorecard (OQS) is a joint project by the Implementation Branch and Health Analytics Branch.
The analyses contained in this report are made to reflect the recommendations of the Orthopaedic Expert Panel at Health Quality Ontario regarding patient cohort selection. Patient cohorts were developed for the implementation of the Quality Based Procedures and as such are used in calculating the indicators in this report. Providers may use the information to track improvements against the implemenation of recommended best-practice in the care of these patients.
As legislated in Ontario’s Excellent Care for All Act, Health Quality Ontario’s mandate includes the provision of objective, evidence-informed advice about opportunities to improve quality and efficiency in the health care system. As part of its Quality-Based Funding initiative, Health Quality Ontario works with multidisciplinary expert panels (composed of leading clinicians, scientists, and administrators) to develop evidence-based practice recommendations and define episodes of care for selected disease areas or procedures. For more information on Health Quality Ontario’s Quality-Based Funding initiative, visit www.hqontario.ca.
This report has been updated from previous reports to present data for the hip replacement and knee replacement patient cohorts separately. The data presented in this way provides more detailed information for tracking improvements against each of these types of patients.
The main difference in the patient cohort as defined for this report compared to those previously reported from Cancer Care Ontario (CCO) is that bilateral replacements are now included . Patients undergoing bilateral surgeries comprised 1.5% of all primary hip knee replacements in FY 2011/12 and had average and median lengths of stay greater than their unilateral replacement counterparts (approximately 1 to 1.5 days longer on average).
As noted above, all indicators are presented on separate tabs for the hip and the knee patient cohorts.
Due to these changes the report does not include trending graphs or tables. Trending information will be presented as more data become available using the new cohorts.
Provincial LevelThe proportion of patients discharged 'Home' is 89% for hip and 92% for knee replacements.
The proportion of patients discharged home meeting the 4.4 day target length of stay is 88% for hip and 90% for knee replacements.
The 90th percentile for the target of 7 day length of stay is met for both hip and knee replacements, with 98% of patients in each group with hospital stay completed within 7 days.
Wait times for both hip and knee replacements are above the targeted 182 days, being 190 days for hip and 225 days for knee replacements.
Changes from reports by CancerCare Ontario
Jan-14
Ministry of Health and Long-Term CareOrthopaedic Quality ScorecardPrimary Hip Knee Replacement, Q2 2013/14
Regional LevelThere is variation across LHINs with respect to the percent of hip and knee replacement patients discharged home and the percent of these patients that meet the targets for length of stay in hospital.
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Percent of patients discharged home with stay completed within 4.4 days1 (Q2 2013/14)
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Knee
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Percent of patients discharged home (Q2 2013/14)
Hip
Knee
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Percent of patients discharged home with hospital stay completed within 7 days (Q2 2013/14)
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Knee
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1Target for hosptial stay
Jan-14
Ministry of Health and Long-Term CareOrthopaedic Quality ScorecardPrimary Hip Knee Replacement, Q2 2013/14
Contact:
Questions related to the analysis provided in this spreadsheet can be directed to:Health Analytics Branch [email protected]
Other questions can be directed to:Implementation Branch [email protected]
The Health Analytics Branch (HAB), in the Ministry of Health and Long-Term Care, provides high quality information, analyses and methodological support to enhance evidence-based decision making in the health system. As part of the Health System Information Management and Investment (HSIMI) Division, HAB manages health analytics requests, identifies methods, and creates reports and tools to meet ministry, LHIN and other client needs for accurate, timely and useful information.
Quality Dimensions Indicator Current Performance Target% Completed Within
Target
Average length of stay (days) - All patients 3.9 - -
Average length of stay (days) - Patients Discharged Home1 3.4 4.4 88.0
90th percentile for 7 day length of stay - Patients Discharged Home1 97.8 90% 97.8
Proportion of Patients Discharged Home 89.2 90% ±9% 89.2
Rate of Readmission within 30 days after primary joint replacement 3.4 - -
Rate of Revisions within 365 days after primary joint replacement 1.6 - -
Accessibility Replacement Wait Time (90th Percentile Days) 190 182 -
Quality Dimensions Indicator Current Performance Target% Completed Within
Target
Average length of stay (days) - All patients 3.5 - -
Average length of stay (days) - Patients Discharged Home1 3.3 4.4 89.5
90th percentile for 7 day length of stay - Patients Discharged Home1 98.1 90% 98.1
Proportion of Patients Discharged Home 92.2 90% ±9% 92.2
Rate of Readmission within 30 days after primary joint replacement 3.2 - -
Rate of Revisions within 365 days after primary joint replacement 1.1 - -
AccessibilityReplacement Wait Time (90th Percentile Days) 225 182 -
Note:
1 Discharge destination Home includes Home Care, Senior's Care, Attendant Care (Discharge type = 04, 05)Please refer to indicator definitions worksheet for full description
PROVINCE
PROVINCE
Efficiency
Effectiveness/Safety
Provincial Orthopaedic Quality Scorecard - HIP Replacement SurgeryReporting Period - Q2 FY 13/14
CHATAM KENT ALLIANCE 352 365HOTEL-DIEU GRACE HOSPITAL 207 NVWINDSOR REGIONAL HOSPITAL 110 140BLUEWATER HEALTH 111 97
South West 181 202ST.JOSEPH'S HEALTH CARE,LONDON NV NVST THOMAS-ELGIN GENERAL HOSPITAL 96 NVSTRATFORD GENERAL HOSPITAL 208 NVSTRATHROY MIDDLESEX GENERAL HOSPITAL 169 NVWOODSTOCK GENERAL HOSPITAL 345 NVLONDON HLTH SCIENCES CTR 191 201GREY BRUCE HEALTH SERVICES 100 118
Waterloo Wellington 118 157CAMBRIDGE MEMORIAL HOSPITAL 306 319GUELPH GENERAL HOSPITAL 140 157GRAND RIVER HOSPITAL CORP 100 79
Hamilton Niagara Haldimand Brant 237 210ST JOSEPH'S HEALTH CARE SYSTEM-HAMILTON 174 236JOSEPH BRANT MEMORIAL HOSPITAL 307 100HAMILTON HEALTH SCIENCES CORP 226 210NIAGARA HEALTH SYSTEM 164 149BRANT COMMUNITY HEALTHCARE SYSTEM 407 NV
Central West 230 210WILLIAM OSLER HEALTH CENTRE 230 210
Mississauga Halton 115 133CREDIT VALLEY HOSPITAL 59 61TRILLIUM HEALTH CENTRE 114 133HALTON HEALTHCARE SERVICES CORP 155 174
Toronto Central 153 158
Orthopaedic Quality Scorecard - Hip Replacement SurgeryReporting Period - Q2 FY 13/14
Quality Dimension - Accessibility
Outside target
90th Percentile wait time (days) Quarter (Q1 FY 13/14) 90th Percentile wait time (days) Month (Dec 2013)Ontario 190 208
Orthopaedic Quality Scorecard - Hip Replacement SurgeryReporting Period - Q2 FY 13/14
Quality Dimension - Accessibility
Outside target
MOUNT SINAI HOSPITAL 131 157ST MICHAEL'S HOSPITAL 256 436TORONTO EAST GENERAL HOSPITAL (THE) 106 NVST JOSEPH'S HEALTH CENTRE 260 NVUNIVERSITY HEALTH NETWORK 137 111SUNNYBROOK HEALTH SCIENCES CENTRE 120 124
Central 127 172NORTH YORK GENERAL HOSPITAL 119 91YORK CENTRAL HOSPITAL 116 184SOUTHLAKE REGIONAL HEALTH CENTRE 145 185MARKHAM STOUFFVILLE HOSPITAL 180 NVHUMBER RIVER REGIONAL HOSP 153 125
Central East 186 195ROSS MEMORIAL HOSPITAL 192 NVPETERBOROUGH REGIONAL HEALTH CENTRE 148 NVLAKERIDGE HEALTH CORPORATION 243 NVROUGE VALLEY HEALTH SYSTEM 134 305SCARBOROUGH HOSPITAL (THE) 202 195
South East 161 223BROCKVILLE GENERAL HOSPITAL 118 NVHOTEL DIEU HOSPITAL 185 NVKINGSTON GENERAL HOSPITAL 176 252PERTH & SMITHS FALLS DIST 104 NVQUINTE HEALTHCARE CORPORATION 161 132
Champlain 328 326KEMPTVILLE DISTRICT HOSPITAL 357 NVHOPITAL MONTFORT 177 207QUEENSWAY-CARLETON HOSPITAL 143 105OTTAWA HOSPITAL 411 420CORNWALL COMMUNITY HOSP-GENERAL SITE 190 NV
90th Percentile wait time (days) Quarter (Q1 FY 13/14) 90th Percentile wait time (days) Month (Dec 2013)Ontario 190 208
Orthopaedic Quality Scorecard - Hip Replacement SurgeryReporting Period - Q2 FY 13/14
Quality Dimension - Accessibility
Outside target
North Simcoe Muskoka 183 151ROYAL VICTORIA HOSPITAL 171 87COLLINGWOOD GENERAL AND MARINE HOSPITAL 507 NVORILLIA SOLDIERS' MEMORIAL HOSPITAL 140 NV
North East 240 241TIMMINS & DISTRICT GENERAL HOSPITAL NV NVWEST PARRY SOUND HEALTH CENTRE 130 NVHOPITAL REGIONAL DE SUDBURY 240 246SAULT AREA HOSPITAL 538 NVNORTH BAY REGIONAL HEALTH CENTRE 116 NV
North West 261 186DRYDEN REGIONAL HEALTH CENTRE 84 NVLAKE-OF-THE-WOODS DISTRICT HOSPITAL NV NVRIVERSIDE HEALTH CARE FAC NV NVTHUNDER BAY REGIONAL HLTH SCIENCES CTR 282 193
CHATAM KENT ALLIANCE 407 459HOTEL-DIEU GRACE HOSPITAL 162 NVWINDSOR REGIONAL HOSPITAL 300 209BLUEWATER HEALTH 144 118
South West 238 226ST.JOSEPH'S HEALTH CARE,LONDON NV NVST THOMAS-ELGIN GENERAL HOSPITAL 92 130STRATFORD GENERAL HOSPITAL 202 291STRATHROY MIDDLESEX GENERAL HOSPITAL 143 172WOODSTOCK GENERAL HOSPITAL 401 NVLONDON HLTH SCIENCES CTR 242 247GREY BRUCE HEALTH SERVICES 104 88
Waterloo Wellington 145 414CAMBRIDGE MEMORIAL HOSPITAL 358 535GUELPH GENERAL HOSPITAL 155 174GRAND RIVER HOSPITAL CORP 112 89
Hamilton Niagara Haldimand Brant 244 218ST JOSEPH'S HEALTH CARE SYSTEM-HAMILTON 225 227JOSEPH BRANT MEMORIAL HOSPITAL 244 158HAMILTON HEALTH SCIENCES CORP 238 162NIAGARA HEALTH SYSTEM 192 208BRANT COMMUNITY HEALTHCARE SYSTEM 486 320
Central West 279 292WILLIAM OSLER HEALTH CENTRE 279 292
Mississauga Halton 171 146CREDIT VALLEY HOSPITAL 98 116TRILLIUM HEALTH CENTRE 265 160HALTON HEALTHCARE SERVICES CORP 212 146
MOUNT SINAI HOSPITAL 129 NVST MICHAEL'S HOSPITAL 166 99TORONTO EAST GENERAL HOSPITAL (THE) 253 237ST JOSEPH'S HEALTH CENTRE 460 494UNIVERSITY HEALTH NETWORK 141 105SUNNYBROOK HEALTH SCIENCES CENTRE 132 162
Central 166 188NORTH YORK GENERAL HOSPITAL 133 132YORK CENTRAL HOSPITAL 180 263SOUTHLAKE REGIONAL HEALTH CENTRE 175 170MARKHAM STOUFFVILLE HOSPITAL 175 218HUMBER RIVER REGIONAL HOSP 156 213
Central East 177 164ROSS MEMORIAL HOSPITAL 175 NVPETERBOROUGH REGIONAL HEALTH CENTRE 95 NVLAKERIDGE HEALTH CORPORATION 176 98ROUGE VALLEY HEALTH SYSTEM 156 171SCARBOROUGH HOSPITAL (THE) 209 170
South East 154 124BROCKVILLE GENERAL HOSPITAL 104 95HOTEL DIEU HOSPITAL 101 NVKINGSTON GENERAL HOSPITAL 149 124PERTH & SMITHS FALLS DIST NV NVQUINTE HEALTHCARE CORPORATION 178 133
Champlain 246 283KEMPTVILLE DISTRICT HOSPITAL 230 307HOPITAL MONTFORT 246 201QUEENSWAY-CARLETON HOSPITAL 142 150OTTAWA HOSPITAL 309 361CORNWALL COMMUNITY HOSP-GENERAL SITE 321 433
90th Percentile wait time (days) Quarter (Q1 FY 13/14) 90th Percentile wait time (days) Month (Dec 2013)Ontario 225 219
North Simcoe Muskoka 219 212ROYAL VICTORIA HOSPITAL 189 113COLLINGWOOD GENERAL AND MARINE HOSPITAL 615 NVORILLIA SOLDIERS' MEMORIAL HOSPITAL 125 NV
North East 278 247TIMMINS & DISTRICT GENERAL HOSPITAL 688 NVWEST PARRY SOUND HEALTH CENTRE 130 NVHOPITAL REGIONAL DE SUDBURY 274 271SAULT AREA HOSPITAL 425 625NORTH BAY REGIONAL HEALTH CENTRE 133 85
North West 237 252DRYDEN REGIONAL HEALTH CENTRE NV NVLAKE-OF-THE-WOODS DISTRICT HOSPITAL NV NVRIVERSIDE HEALTH CARE FAC 56 NVTHUNDER BAY REGIONAL HLTH SCIENCES CTR 272 254
Rate of Readmission within 30 days after primary joint replacement
Rate of Revision within 365 days after primary joint replacement
Ontario 3.4 1.6Erie St.Clair 3.5 2.7
CHATAM KENT ALLIANCE 2.4 2.0HOTEL-DIEU GRACE HOSPITAL 3.2 3.4WINDSOR REGIONAL HOSPITAL 0.0* 0.0BLUEWATER HEALTH 5.4 2.7
South West 3.0 1.9ST.JOSEPH'S HEALTH CARE,LONDON NV 5.3*ST THOMAS-ELGIN GENERAL HOSPITAL 0.0* 0.0STRATFORD GENERAL HOSPITAL 6.3 0.0STRATHROY MIDDLESEX GENERAL HOSPITAL 0.0* 2.2WOODSTOCK GENERAL HOSPITAL 0.0* 0.0LONDON HLTH SCIENCES CTR 3.6 3.1GREY BRUCE HEALTH SERVICES 2.0 1.4
Waterloo Wellington 4.1 0.9CAMBRIDGE MEMORIAL HOSPITAL 3.0 0.7GUELPH GENERAL HOSPITAL 7.3 0.6GRAND RIVER HOSPITAL CORP 3.2 1.2
Hamilton Niagara Haldimand Brant 3.6 1.5ST JOSEPH'S HEALTH CARE SYSTEM-HAMILTON 12.5 0.6JOSEPH BRANT MEMORIAL HOSPITAL 1.9 1.1HAMILTON HEALTH SCIENCES CORP 3.2 2.2NIAGARA HEALTH SYSTEM 0.0 1.5BRANT COMMUNITY HEALTHCARE SYSTEM 8.1 0.0
Central West 0.0 1.4WILLIAM OSLER HEALTH CENTRE 0.0 1.4
Mississauga Halton 5.8 1.6HALTON HEALTHCARE SERVICES CORP 8.5 0.8TRILLIUM HEALTH CENTRE 4.3 2.0
Toronto Central 2.7 0.9MOUNT SINAI HOSPITAL 2.0 1.6
Orthopaedic Quality Scorecard - Hip Replacement SurgeryReporting Period - Q2 FY 13/14
Quality Dimension - Effectiveness/Safety
NV = No cases * = Low volume (<=25 cases)
Rate of Readmission within 30 days after primary joint replacement
Rate of Revision within 365 days after primary joint replacement
Ontario 3.4 1.6
Orthopaedic Quality Scorecard - Hip Replacement SurgeryReporting Period - Q2 FY 13/14
Quality Dimension - Effectiveness/Safety
NV = No cases * = Low volume (<=25 cases)
ST MICHAEL'S HOSPITAL 0.9 0.5TORONTO EAST GENERAL HOSPITAL (THE) 3.6 0.6ST JOSEPH'S HEALTH CENTRE 10.3 2.5UNIVERSITY HEALTH NETWORK 1.6 1.1SUNNYBROOK HEALTH SCIENCES CENTRE 3.1 0.8
Central 3.4 1.8NORTH YORK GENERAL HOSPITAL 3.0 1.7YORK CENTRAL HOSPITAL 4.3* 1.8SOUTHLAKE REGIONAL HEALTH CENTRE 7.7 1.8MARKHAM STOUFFVILLE HOSPITAL 0.0 0.0HUMBER RIVER REGIONAL HOSP 1.9 3.4
Central East 3.0 0.9ROSS MEMORIAL HOSPITAL 4.8* 0.0PETERBOROUGH REGIONAL HEALTH CENTRE 2.0 1.3LAKERIDGE HEALTH CORPORATION 4.0 0.0ROUGE VALLEY HEALTH SYSTEM 5.0* 2.0SCARBOROUGH HOSPITAL (THE) 1.6 0.7
South East 4.3 2.3BROCKVILLE GENERAL HOSPITAL 16.7* 2.4HOTEL DIEU HOSPITAL NV NVKINGSTON GENERAL HOSPITAL 1.9 2.0PERTH & SMITHS FALLS DIST 8.6 1.0QUINTE HEALTHCARE CORPORATION 0.0 3.1
Champlain 2.9 2.5KEMPTVILLE DISTRICT HOSPITAL 0.0* 0.0*HOPITAL MONTFORT 1.7 1.0QUEENSWAY-CARLETON HOSPITAL 3.2 3.8OTTAWA HOSPITAL 2.9 2.2CORNWALL COMMUNITY HOSP-GENERAL SITE 8.3* 0.0
North Simcoe Muskoka 2.9 1.4
Rate of Readmission within 30 days after primary joint replacement
Rate of Revision within 365 days after primary joint replacement
Ontario 3.4 1.6
Orthopaedic Quality Scorecard - Hip Replacement SurgeryReporting Period - Q2 FY 13/14
Quality Dimension - Effectiveness/Safety
NV = No cases * = Low volume (<=25 cases)
ROYAL VICTORIA HOSPITAL 4.5 1.4COLLINGWOOD GENERAL AND MARINE HOSPITAL 0.0* 1.8ORILLIA SOLDIERS' MEMORIAL HOSPITAL 0.0* 0.0
North East 5.0 0.7TIMMINS & DISTRICT GENERAL HOSPITAL 20.0* 0.0*WEST PARRY SOUND HEALTH CENTRE 7.7* 0.0HOPITAL REGIONAL DE SUDBURY 4.0 0.0SAULT AREA HOSPITAL 7.3 1.8NORTH BAY REGIONAL HEALTH CENTRE 0.0 1.8
North West 5.8 2.8DRYDEN REGIONAL HEALTH CENTRE 18.2* 2.8LAKE-OF-THE-WOODS DISTRICT HOSPITAL NV NVRIVERSIDE HEALTH CARE FAC NV NVTHUNDER BAY REGIONAL HLTH SCIENCES CTR 3.4 2.8
Rate of Readmission within 30 days after primary joint replacement
Rate of Revision within 365 days after primary joint replacement
Ontario 3.2 1.1Erie St.Clair 3.4 1.5
CHATAM KENT ALLIANCE 3.3 0.3HOTEL-DIEU GRACE HOSPITAL 3.8 2.9WINDSOR REGIONAL HOSPITAL 1.6 0.8BLUEWATER HEALTH 4.5 1.6
South West 5.2 1.3ST.JOSEPH'S HEALTH CARE,LONDON NV 2.8ST THOMAS-ELGIN GENERAL HOSPITAL 11.4 0.8STRATFORD GENERAL HOSPITAL 3.3 0.7STRATHROY MIDDLESEX GENERAL HOSPITAL 5.4 0.0WOODSTOCK GENERAL HOSPITAL 8.1 1.4LONDON HLTH SCIENCES CTR 5.0 1.4GREY BRUCE HEALTH SERVICES 3.2 1.7
Waterloo Wellington 2.1 0.5CAMBRIDGE MEMORIAL HOSPITAL 5.1 0.6GUELPH GENERAL HOSPITAL 2.4 0.4GRAND RIVER HOSPITAL CORP 1.1 0.4
Hamilton Niagara Haldimand Brant 3.4 1.0ST JOSEPH'S HEALTH CARE SYSTEM-HAMILTON 5.0 1.4JOSEPH BRANT MEMORIAL HOSPITAL 2.4 0.3HAMILTON HEALTH SCIENCES CORP 3.8 1.3NIAGARA HEALTH SYSTEM 2.9 1.2BRANT COMMUNITY HEALTHCARE SYSTEM 2.9 0.6
Central West 3.0 0.2WILLIAM OSLER HEALTH CENTRE 3.0 0.2
Mississauga Halton 2.1 0.6HALTON HEALTHCARE SERVICES CORP 1.3 0.6TRILLIUM HEALTH CENTRE 2.4 0.6
Toronto Central 2.5 1.1MOUNT SINAI HOSPITAL 4.5 0.9
ST MICHAEL'S HOSPITAL 7.0 0.7TORONTO EAST GENERAL HOSPITAL (THE) 3.5 1.2ST JOSEPH'S HEALTH CENTRE 1.6 1.4UNIVERSITY HEALTH NETWORK 2.1 1.2SUNNYBROOK HEALTH SCIENCES CENTRE 0.7 1.1
Central 2.9 1.4NORTH YORK GENERAL HOSPITAL 2.6 1.7YORK CENTRAL HOSPITAL 4.5 2.1SOUTHLAKE REGIONAL HEALTH CENTRE 2.9 1.2MARKHAM STOUFFVILLE HOSPITAL 1.4 0.8HUMBER RIVER REGIONAL HOSP 3.0 1.2
Central East 3.6 1.2ROSS MEMORIAL HOSPITAL 6.0 1.8PETERBOROUGH REGIONAL HEALTH CENTRE 4.6 0.8LAKERIDGE HEALTH CORPORATION 2.2 0.3ROUGE VALLEY HEALTH SYSTEM 1.3 1.1SCARBOROUGH HOSPITAL (THE) 4.0 1.6
South East 2.8 1.2BROCKVILLE GENERAL HOSPITAL 1.5 2.7HOTEL DIEU HOSPITAL NV NVKINGSTON GENERAL HOSPITAL 1.5 2.5PERTH & SMITHS FALLS DIST 0.0 0.5QUINTE HEALTHCARE CORPORATION 6.2 0.0
Champlain 3.2 1.4KEMPTVILLE DISTRICT HOSPITAL 3.6 1.5HOPITAL MONTFORT 3.5 0.8QUEENSWAY-CARLETON HOSPITAL 2.9 1.6OTTAWA HOSPITAL 3.8 1.1CORNWALL COMMUNITY HOSP-GENERAL SITE 0.0* 4.6
North Simcoe Muskoka 4.9 0.5
Rate of Readmission within 30 days after primary joint replacement
Rate of Revision within 365 days after primary joint replacement
ROYAL VICTORIA HOSPITAL 5.5 0.5COLLINGWOOD GENERAL AND MARINE HOSPITAL 0.0* 0.0ORILLIA SOLDIERS' MEMORIAL HOSPITAL 7.1* 1.6
North East 2.4 1.9TIMMINS & DISTRICT GENERAL HOSPITAL 0.0* 0.0WEST PARRY SOUND HEALTH CENTRE 0.0* 0.0HOPITAL REGIONAL DE SUDBURY 1.7 1.7SAULT AREA HOSPITAL 4.9 3.5NORTH BAY REGIONAL HEALTH CENTRE 2.2 2.1
North West 8.3 0.6DRYDEN REGIONAL HEALTH CENTRE 6.3* 2.6LAKE-OF-THE-WOODS DISTRICT HOSPITAL 0.0* 0.0*RIVERSIDE HEALTH CARE FAC 6.3* 0.0THUNDER BAY REGIONAL HLTH SCIENCES CTR 9.8 0.3
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1Data Source Frequency of Data Collection• CIHI DAD • QuarterlyRationale•Measure Description•Methods Notes
Inclusions:• Inpatient population reported based on Discharge Date for the reporting period• Elective patients – 'Admission Category' = "L"• Primary hip and knee replacement procedures • Patients 18 years and older on the day the procedure was completed•• CCI codes 1.VA.53.^^, 1.VG.53.^^
Exclusions:•• Intervention Status Attribute ' NE "R" to exclude revisions• Primary Cement Spacer procedure with CCI codes 1.VA.53.LA-SL-N and 1.VG.53.LA-SL-N attribute status = 0.
Notes:•Data Quality & Limitations• Quarterly CIHI DAD is available two months after the end of the reporting quarter•
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Data Source Frequency of Data Collection• CIHI DAD • QuarterlyRationale• The purpose of this indicator is to report on the mean (average) LOS for patients discharged home• Length of stay is an indicator of quality of care.• The established current provincial target is 4.4 daysMeasure Description•Methods Notes
Numerator = [Sum of individual length of stays over the specified period of time for valid patients]Denominator = [Count of valid cases over the specified period of time]
Inclusions:• Inpatient population reported based on "Discharge Date" for the reporting period• Elective patients – 'Admission Category' = "L"• Primary hip and knee replacement procedures • Patients 18 years and older on the day the procedure was completed•• Only patients discharged to home - Discharge Type = 04 and 05• CCI codes 1.VA.53.^^, 1.VG.53.^^
Exclusions:•• Intervention Status Attribute ' NE "R" to exclude revisions• Primary Cement Spacer procedure with CCI codes 1.VA.53.LA-SL-N and 1.VG.53.LA-SL-N attribute status = 0.
Notes:• The average length of stay will be presented as days to one decimal place •
Data Quality & Limitations• Quarterly CIHI DAD is available two months after the end of the reporting quarter•
Back to Top3
Data Source Frequency of Data Collection• CIHI DAD • QuarterlyRationale••
Measure Description
Primary Hip and Knee Replacement Surgery Orthopaedic Quality Scorecard - Indicators Dictionary
IndicatorsLength of Stay - All Patients (Average Days)Length of Stay - Patients Discharged Home (Average Days)Length of Stay - Patients Discharged Home (Median Days)Length of Stay - Patients Discharged Home (90th Percentile Days)
Average length of stay for all hip and knee joint replacement patients
The purpose of this indicator is to report the length of stay for all patients who have hip or knee joint replacement, regardless of
The Average length of stay in acute care for all primary unilateral hip of knee joint replacement patients regardless of discharge
Numerator = [Sum of all lengths of stay over the specified period of time for valid patients]Denominator = [Count of all valid patient over the specified period of time]Average length of stay = [Sum of all lengths of stay over the specified period of time for valid patients] / [Count of all valid patients
Proportion of Patients Discharged HomeRate of Readmissionwithin 30 days after primary joint replacementRate of Revision within 365 days after primary joint replacementPrimary Hip and Knee Replacement Wait Time (90th Percentile days)Percent completed within 4.4 days (LOS indicator)Percent completed within 7 days (LOS indicator)
Mean length of stay = [Sum of individual length of stays over the specified period of time for valid patients] / [Count of valid cases
Valid patient = the patient who has a valid record for a specific data element and corresponds to the inclusion and exclusion criteria.
Patients where primary (most responsible) condition for joint replacement is Cancer (ICD-10 Chapter code= 'C' and 'D') or Trauma
Length of stay is the time period from the date and time of admission to acute care to the date and time of discharge from acute
Quarterly data undergoes data quality processes prior to year end and results after year end closes will be the most accurate
Median length of stay for patients discharged directly home after primary hip or knee joint replacement surgery
Valid patient = the patient who has a valid record for a specific data element and corresponds to the inclusion and exclusion criteria.
Patients where primary (most responsible) condition for joint replacement is Cancer (ICD-10 Chapter code= 'C' and 'D') or Trauma
Length of stay is the time period from the date and time of admission to acute care to the date and time of discharge from acute
Quarterly data undergoes data quality processes prior to year end and results after year end closes will be the most accurate
Average length of stay for patients discharged directly home after primary hip or knee joint replacement surgery
The mean length of stay in acute care for primary hip or knee joint replacement patients who are discharged from acute care
The purpose of this indicator is to report the length of stay at which point 50 % of patients have been dischargedThe median is less sensitive to extreme scores than the mean, which makes the median a better measure for highly skewed
•Methods Notes
Inclusions:• Inpatient population reported based on "Discharge Date" for the reporting period• Elective patients – 'Admission Category' = "L"• Primary hip and knee replacement procedures • Patients 18 years and older on the day the procedure was completed•• Only patients discharged to home - Discharge Type = 04 and 05• CCI codes 1.VA.53.^^, 1.VG.53.^^
Exclusions:•• Intervention Status Attribute ' NE "R" to exclude revisions• Primary Cement Spacer procedure with CCI codes 1.VA.53.LA-SL-N and 1.VG.53.LA-SL-N attribute status = 0.
Notes:•
Data Quality & Limitations• Quarterly CIHI DAD is available two months after the end of the reporting quarter•
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Data Source Frequency of Data Collection• CIHI DAD • QuarterlyRationale• The purpose of this indicator is to report the 90th percentile LOS for patients discharged home• Length of stay is an indicator of quality of care.• The established current provincial target is 7 daysMeasure Description•Methods Notes
Inclusions:• Inpatient population reported based on "Discharge Date" for the reporting period• Elective patients – 'Admission Category' = "L"• Primary hip and knee replacement procedures • Patients 18 years and older on the day the procedure was completed•• Only patients discharged to home - Discharge Type = 04 and 05• CCI codes 1.VA.53.^^, 1.VG.53.^^
Exclusions:•• Intervention Status Attribute ' NE "R" to exclude revisions• Primary Cement Spacer procedure with CCI codes 1.VA.53.LA-SL-N and 1.VG.53.LA-SL-N attribute status = 0.
Notes:• The 90th percentile length of stay in days to one decimal place •
Data Quality & Limitations• Quarterly CIHI DAD is available two months after the end of the reporting quarter•
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Data Source Frequency of Data Collection• CIHI DAD • QuarterlyRationale••• The LHIN level target has been set for 90 % of patients discharged home.• LHINs can negotiate hospital performance within a corridor of +/- 9% (81% to 99%)
Measure Description• The percentage of hip or knee joint replacement patients discharged from acute care directly home.Methods Notes
Numerator = [Count of all valid patients discharged directly home over a specified period of time]Denominator = [Count of all valid patients over the specified period of time]Proportion of Patients Discharged Directly Home from Acute Care =
Inclusions:• Inpatient population reported based on Discharge Date for the reporting period• Elective patients – 'Admission Category' = "L"• Primary hip and knee replacement procedures • Patients 18 years and older on the day the procedure was completed• Patients who were discharged directly home from acute care for numerator only• All valid patients for the denominator regardless of discharge destination•• CCI codes 1.VA.53.^^, 1.VG.53.^^
Exclusions:•• Intervention Status Attribute ' NE "R" to exclude revisions• Primary Cement Spacer procedure with CCI codes 1.VA.53.LA-SL-N and 1.VG.53.LA-SL-N attribute status = 0.
Notes:• The percentage of patients discharged directly home to one decimal point.
Length of stay is the time period from the date and time of admission to acute care to the date and time of discharge from acute
Quarterly data undergoes data quality processes prior to year end and results after year end closes will be the most accurate
90th percentile length of stay for patients discharged directly home after primary hip or knee joint replacement surgery
90th percentile is the length of stay for the 9 out of 10 patients if ordered from shortest to longest length of stay.
90th percentile is the length of stay for the 9 out of 10 patients if ordered from shortest to longest length of stay.
Valid patient = the patient who has a valid record for a specific data element and corresponds to the inclusion and exclusion criteria.
The median is the number of days within which half of the patients in the specified time period were discharged home
Median length of stay is the value for LOS for a patient positioned in the middle of the list ordered from the lower to the highest
Valid patient = the patient who has a valid record for a specific data element and corresponds to the inclusion and exclusion criteria.
Patients where primary (most responsible) condition for joint replacement is Cancer (ICD-10 Chapter code= 'C' and 'D') or Trauma
([Count of all valid patients discharged directly home over a specified period of time] / [Count of all valid patients over the specified
Valid patient = the patient who has a valid record for a specific data element and corresponds to the inclusion and exclusion criteria.
Patients where primary (most responsible) condition for joint replacement is Cancer (ICD-10 Chapter code= 'C' and 'D') or Trauma
Patients where primary (most responsible) condition for joint replacement is Cancer (ICD-10 Chapter code= 'C' and 'D') or Trauma
Length of stay is the time period from the date and time of admission to acute care to the date and time of discharge from acute
Quarterly data undergoes data quality processes prior to year end and results after year end closes will be the most accurate
Proportion of patients discharged to home after primary hip and knee joint replacement surgery
To report the proportion (percentage) of patients discharged home of all patients who have hip or knee joint replacement.Evidence identifies that after hip or knee joint replacement most patients can be discharged directly to home.
Data Quality & Limitations• Quarterly CIHI DAD is available two months after the end of the reporting quarter•
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Data Source Frequency of Data Collection• CIHI DAD • QuarterlyRationale•• No target has been set at this time for the readmission indicator.Measure Description•Methods Notes
Proportion of patients readmitted within 30 days = Numerator/Denominator * 100
Inclusions for Denominator:• Inpatient population reported based on Discharge Date for the reporting period• Elective patients – 'Admission Category' = "L"• Primary hip and knee replacement procedures • Patients 18 years and older on the day the procedure was completed• Primary joint procedure – 'Attribute status' NE "R" for primary (included in denominator)• For patients with multiple primaries, only the most recent primary intervention is included•• CCI codes 1.VA.53.^^, 1.VG.53.^^
Exclusions for Denominator•• Primary Cement Spacer procedure with CCI codes 1.VA.53.LA-SL-N and 1.VG.53.LA-SL-N attribute status = 0.
Inclusions for Numerator:••
Exclusions for Numerator:•• All Elective readmissions (Admission Category = L)•
Notes:• The readmission rate for a hospital is attributed to the hospital where the primary surgery took place.• The readmission rate for a LHIN is attributed to the LHIN where the primary surgery took place.•
Example: Reporting Quarter is Q2 FY 10/11 - July 1, 2010 to Sept 30, 2010
Data Quality & Limitations• Quarterly CIHI DAD is available two months after the end of the reporting quarter•
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Data Source Frequency of Data Collection• CIHI DAD • QuarterlyRationale•• No target has been set at this time for the revision indicator.Measure Description•• The rate of revision is measured from discharge date (primary surgery) to admission date (revision surgery)• The rate of the revisions on a monthly or quarterly basis are very lowMethods Notes
Revision rate = Numerator/Denominator * 100
Inclusions for Denominator:• Inpatient population reported with primary hip and knee surgery• Elective patients – 'Admission Category' = "L"• Patients 18 years and older on the day the primary procedure was completed•••• CCI codes 1.VA.53.^^, 1.VG.53.^^
Inclusions for Numerator:••• CCI codes 1.VA.53.^^, 1.SQ.53.^^, 1.VG.53.^^ (only revision codes for 1.SQ.53 are included) • Both elective and urgent revisions are included
Exclusions for Denominator•• Patients with multiple primaries. It is difficult to link the revision to a particular primary intervention.• Primary Cement Spacer procedure with CCI codes 1.VA.53.LA-SL-N and 1.VG.53.LA-SL-N attribute status = 0.
Notes:• The revision rate for a hospital is attributed to the hospital where the primary surgery took place.• The revision rate for a LHIN is attributed to the LHIN where the primary surgery took place.
Quarterly data undergoes data quality processes prior to year end and results after year end closes will be the most accurate
Rate of Readmission within 30 days after primary joint replacement
The purpose of this indicator is to report the percentage of patients readmitted to acute care within 30 days of discharge from
For patients with multiple readmissions, only the earliest readmission is used to calculate the difference between discharge date and
Patients readmitted for another primary total hip and knee within 30 days of discharge from primary total hip and knee
Duplicates identified as transfers within an episode of care
Denominator specified time period is the month prior to the reporting quarter plus the first two months of the reporting quarter.
Denominator specified time period for rate of readmission is from June 1, 2010 to August 31, 2010 (3 months).There is no time period for the numerator as long as the readmission occurred within 30 days after discharge from
The percentage of hip or knee joint replacement patients admitted to acute care within 30 days after discharge from acute care.
Numerator = [Count of primary hip and knee joint replacement patients who were readmitted for any reasons within 30 days from Denominator = [Count of all patients discharged after primary hip or knee joint replacement from acute care for the specified time
Valid patient = the patient who has a valid record for a specific data element and corresponds to the inclusion and exclusion criteria.
Patients where primary (most responsible) condition for joint replacement is Cancer (ICD-10 Chapter code= 'C' and 'D') or Trauma
Subset of selected patients from the denominator group who were readmitted in acute care within 30 days from discharge
Primary hip or knee replacement procedure – 'Attribute status' NE "R" for primary (included in denominator)Patients who were discharged from hospital after primary surgical intervention within 365 days before the end of the reporting Valid patient = the patient who has a valid record for a specific data element and corresponds to the inclusion and exclusion criteria.
Subset of selected patients from the denominator group who received Revision Joint Replacement (Attribute Status = "R") within For patients with multiple revisions, only the earliest revision is used to calculate the difference between discharge date (primary)
Patients where primary (most responsible) condition for joint replacement is Cancer (ICD-10 Chapter code= 'C' and 'D') or Trauma
Quarterly data undergoes data quality processes prior to year end and results after year end closes will be the most accurate
Rate of Revision within 365 days after primary hip or knee joint replacement
The purpose of this indicator is to report the rate (percentage) of patients who underwent a revision joint surgery within 365 days
The percentage of hip and knee joint replacement who received a revision within 365 days of discharge from hospital after primary
Numerator = [Count of primary hip and knee joint replacement patients who had revisions within 365 days from discharge]Denominator = [Count of all patients discharged after primary hip or knee joint replacement from acute care for the specified time
•
Example: Reporting Quarter is Q2 FY 10/11 - July 1, 2010 to Sept 30, 2010
Data Quality & Limitations••
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Data Source Frequency of Data Collection• Wait Time Information System • QuarterlyRationale•• The established provincial target is 182 daysMeasure Description•
Methods NotesWait time = "treatment" date minus "decision to treat" date less patient unavailable days
Inclusions:• Primary total hip and knee replacements with procedure dates within the specified reporting period. • Patients 18 years and older on the day the procedure was completed• Wait List Entries assigned Priority Levels 2,3 and 4 (Elective Cases)
Exclusions:• Procedures no longer required. • Wait list entries identified by hospitals as data entry errors.• Cases with very long waits (if confirmed by hospital). • Priority 1 emergency cases
Notes:
These are considered data entry errors. Data Quality & Limitations••
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Data Source Frequency of Data Collection• CIHI DAD • QuarterlyRationale•Measure Description• The percent of patients discharged home withing the indicator target of 4.4 days.Methods Notes
Numerator = [Count of all valid patients discharged home within 4.4 days over the specified time period]Denominator = [Count of all valid patient discharged home over the specified period of time]Percent discharged within 4.4 days = Numerator/Denominator * 100
Inclusions:• Inpatient population reported based on Discharge Date for the reporting period• Elective patients – 'Admission Category' = "L"• Primary hip and knee replacement procedures • Patients 18 years and older on the day the procedure was completed• Primary joint procedure – 'Attribute status' NE "R" for primary •• Patients with a discharge destination of home; code 04 or 05.
Exclusions:•
Notes:•
Data Quality & Limitations• Quarterly CIHI DAD is available two months after the end of the reporting quarter•
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Data Source Frequency of Data Collection• CIHI DAD • QuarterlyRationale•Measure Description• The percent of patients discharged home withing the indicator target of 7 days.Methods Notes
Numerator = [Count of all valid patients discharged home within 7 days over the specified time period]Denominator = [Count of all valid patient discharged home over the specified period of time]Percent discharged within7days = Numerator/Denominator * 100
Inclusions:• Inpatient population reported based on Discharge Date for the reporting period• Elective patients – 'Admission Category' = "L"• Primary hip and knee replacement procedures • Patients 18 years and older on the day the procedure was completed• Primary joint procedure – 'Attribute status' NE "R" for primary •• Patients with a discharge destination of home; code 04 or 05.
The purpose of this indicator is to report on the wait time of hip and knee patients from Decision to Treat Date to Surgical Procedure
90th percentile is the length of stay for the 9 out of 10 patients if ordered from shortest to longest length of stay. For example, if a 58 days, this means that 9 out of 10 of the patients waited less than 58 days, and the other 10 per cent waited more than 58 days.
If patient unavailable dates fall outside the Decision to Treat Date up to Procedure Date, the patient unavailable dates are not
Data is based on the monthly extract of the Wait Time Information System taken 7-8 days after the end of the month.Data Quality validation/verification with hospitals are done twice a month for accuracy and validity of reported wait time
Denominator specified time period is 4 quarters prior to most recent 4 quarters. The most recent quarter is the reporting quarter.
Denominator specified time period for rate of revision is from October 1, 2008 to September 30, 2009 (1 year data)There is no time period for the numerator as long as the revision occurred within 365 days after discharge to the
Quarterly CIHI DAD is available two months after the end of the reporting quarterQuarterly data undergoes data quality processes prior to year end and results after year end closes will be the most accurate
90th Percentile Wait Time for primary hip or knee joint replacement surgery
Percent completed within 7 days (LOS indicator)
The purpose of this indicator is to report the percent of patients who have hip or knee joint replacementwho and are discharged
Valid patient = the patient who has a valid record for a specific data element and corresponds to the inclusion and exclusion criteria.
Percent completed within 4.4 days (LOS indicator)
The purpose of this indicator is to report the percent of patients who have hip or knee joint replacement who are discharged home
Valid patient = the patient who has a valid record for a specific data element and corresponds to the inclusion and exclusion criteria.
Patients where primary (most responsible) condition for joint replacement is Cancer (ICD-10 Chapter code= 'C' and 'D') or Trauma
Length of stay is the time period from the date and time of admission to acute care to the date and time of discharge from acute
Quarterly data undergoes data quality processes prior to year end and results after year end closes will be the most accurate
Exclusions:•
Notes:•
Data Quality & Limitations• Quarterly CIHI DAD is available two months after the end of the reporting quarter•
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Patients where primary (most responsible) condition for joint replacement is Cancer or Trauma – please see ROW 500 below for the
Length of stay is the time period from the date and time of admission to acute care to the date and time of discharge from acute
Quarterly data undergoes data quality processes prior to year end and results after year end closes will be the most accurate