Introduction: Health quality indicators (i.e. measures) are key to understanding the quality of care and identifing actionable opportunities for improving health system performance. Although indicator development is advancing in stroke rehabilitation, there is still a paucity of indicators for spinal cord injury (SCI) rehabilitation. Current Canadian data is restricted to impairment, length of stay and Functional Independence Measure Efficacy. The aim of the SCI Rehabilitation Care High Performance Indicators (SCI-High) project is to establish a framework of structure, process and outcome indicators within 11 domains of SCI rehabilitation care to improve rehabilitation care from inpatient admission to 18 months post-rehab admission. National Working Groups were formed to select and develop indicators relevant to each Domain. Indicators were divided in structure (infrastructure characteristics), process (processes of care) and outcome (effects of care). Potential indicators were piloted at participating sites to assess the feasibility, inform Standard Operating Procedure (SOP) development and formulation of preliminary benchmarks. Six domains of care - Emotional Well-Being, Sexual Health, Tissue Integrity, Urinary Tract Infection, Walking, and Wheeled Mobility - were prioritized for implementation at five rehabilitation centres in Ontario, Canada.
Workshop aims:
Six domains of rehabilitation will be discussed in terms of: 1) domain prioritization process; 2) indicator development; 3) early deployment; and 4) next steps. Dr. Craven will provide an overview of the general SCI-High Project and primary objectives. Ms. Farnoosh Farahani will present the domain prioritization process for the six domains currently being implemented in Ontario (Emotional Well-Being, Sexual Health, Tissue Integrity, Urinary Tract Infection, Walking, and Wheeled Mobility) and the indicator selection methodology. Dr. O’Connell will discuss in details and present results of the Sexual Health Domain. Other examples including the Emotional Well-Being and Urinary Tract Health domains aligned with the ISCOS 2019 themes will be presented. Finally, the panelists will discuss the implementation process and linkage of the indicators with Accreditation Canada and Health Standards Organization SCI standards.
Workshop learnings: Attendees will become familiar with different types of quality indicators, processes for selection and development of indicators, indicator content, and their associated benchmarks. Participants will review in details select domains that are transferable to other centres internationally. The final goal is to enlighten how quality indicators can be used to drive best-practices implementation and delivery of optimal care.
Disclosures and funding support: Dr. B. Catharine Craven acknowledges support from the Toronto Rehab Foundation as the Toronto Rehabilitation Institute Chair in Spinal Cord Injury Rehabilitation and receipt of consulting fees from The Rick Hansen Institute. Dr. Colleen O’Connell acknowledges support from Cytokinetics, Mallincroft, Orion, Biogen, Rick Hansen Institute and ALS Canada. She has also been a receipt of consulting fees from Ipsen, MT Pharma, Tidal, and Canopy. Ms. Farnoosh Farahani reposts no disclosures or conflicts of interest. The SCI-High Project is supported by the Rick Hansen Institute (Grant #G2015-33), Ontario Neurotrauma Foundation (Grant #2018 RHI HIGH 1057), and Toronto Rehabilitation Foundation.