Mary-Wilson-Trider4by Mary Wilson Trider

The Canadian Institute for Health Information (CIHI) launched “Your Health System” on September 18, a new website that reports a set of indicators for health regions and hospitals across Canada.

Some of the indicators are reported only at the national, provincial and/or regional levels. Hospital-specific data is reported for 2012-13 or for the three years 2010-11 to 2012-13. The focus of reporting is on acute care, which for Almonte General Hospital (AGH) means that the Rosamond Unit is excluded.

Indicators reported at the hospital-specific level for AGH are:

  • 30-day in-hospital mortality following major surgery
  • 30-day overall readmission
  • 30-day medical readmission
  • 30-day surgical readmission
  • 30-day obstetrical readmission
  • Low-risk Caesarean section rate
  • Cost of a standard hospital stay
  • Administrative service expense as a percentage of total expense
  • In-hospital sepsis
  • In addition, there are a number of facility-specific statistics for the 2012-13 fiscal year.

For all of the indicators, a lower number indicates better performance and, generally speaking, AGH performed as well or better than the average of Community-Small Hospitals, Champlain Local Health Integration Network (LHIN) hospitals, Ontario hospitals and Canadian hospitals.

For two of the indicators, however, AGH is reported as below average.

Despite having a lower total cost for a standard hospital stay than all other categories, the Administrative Expense indicator value of 7.4 per cent is reported as higher than average. Unfortunately, CIHI chose not to report a Community-Small Hospitals score for this indicator.

Small hospitals generally have a higher administrative expense ratio because the fixed cost of administrative functions that are required in all hospitals regardless of size (e.g., a payroll department) are spread over a smaller base of direct costs.

AGH staff have compared our administrative expense value against other small hospitals in the Champlain LHIN and found that ours is below average for the group. Despite this, we diligently review administrative costs on an ongoing basis to ensure that we are using our funds wisely.

The “In-hospital sepsis” indicator value of 9.7 is also reported as below average. We are unable to verify the 9.7 rate, which is calculated by CIHI, but we do know that this is a 2012-13 indicator that represents five cases.

At this time, the five charts are being reviewed by three members of our Quality Improvement/Risk Management Committee (QIRM) – a physician, a nurse and a pharmacist – to determine whether there is anything that could or should be done differently to prevent sepsis in the future.

Their findings will be reported to both the QIRM Committee and the Board of Directors and any recommendations will be acted upon.

We do already know, however, that in 2013-14 there were only two cases of sepsis.

Interested members of the community will find the indicators for AGH and all other hospitals at www.ourhealthsystem.ca.

Mary Wilson Trider is President and CEO of Almonte General Hospital and Fairview Manor.