The RCA has released its annual report on rehabilitative care in Ontario.

The 2017/18 Rehabilitative Care System Performance Report reports on eleven indicators within the quality domains of access, safety, effectiveness and integration. Performance is reported against provincial benchmarks for three of the indicators: wait times for inpatient rehabilitative care, wait times for in-home rehabilitative care and repeat emergency department visits due to falls.

This is the third year that the RCA has assessed performance across the province and the report continues to evolve. The 2017/18 report uses an interactive scorecard format to allow easy comparison of data across LHINs, supported by analysis, data tables and technical definitions for each of the indicators.

Highlights from the report

Inpatient rehabilitative care

  • Benchmark: Wait time for inpatient rehabilitative care is three days from most recent discharge destination determined to discharge date
  • 2017/18 results: Many patients in Ontario waited three days or less for their inpatient rehabilitative care stay. Six LHINs had median wait times for NRS reporting beds that were three days or less, and all LHINs had median wait times for these beds under six days. In general, wait times have not significantly changed year over year in the past three years.

In-home rehabilitative care

  • Benchmark: Wait time for in-home rehabilitative care services is five days from patient available date to first visit by regulated health professional
  • 2017/18 results: Many patients in Ontario waited five days or less for in-home rehabilitative care services. Wait times varied across LHINs and also varied by type of regulated health professional patients waited for (e.g., waits were longer for social work and speech language pathology). Median wait times ranged from two to 14 days. In general, wait times have not significantly changed year over year in the past three years.

Repeat ED visits for falls

  • Benchmark: 646 repeat ED visits for falls in the last fiscal year per 100,000 people aged 65 years and older
  • 2017/18 results: The age standardized rate of repeat ED visits for falls among those 65 years and over ranged from 515 to 1,081 per 100,000. In 2017, there were 132,063 ED visits for falls among seniors in Ontario; of those, 12 to 18 per cent were repeat visits.

Toolkit to support QI work at LHIN level

The report is provided to LHINs to help them focus their quality improvement (QI) efforts and the RCA is developing additional resources to support that work. A panel of subject matter experts has been convened for each benchmarked indicator to complete a root cause analysis at a provincial level and to develop a number of QI change ideas. These ideas, together with the process followed by the panels, will be included in a QI toolkit to be released in spring 2019.

Work has also begun to identify opportunities to improve future versions of the performance report.  The RCA’s System Evaluation Task and Advisory Groups have reviewed the original Rehabilitative Care System Evaluation Framework of 39 indicators and selected six for additional work to determine whether data is, or can be, collected using standardized definitions and methods.

For more information, email info@rehabcarealliance.ca.