200810 HAPSHSAA PAO Indicators: Hospital Service Volumes

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• 2008-10 HAPS/H-SAA PAO Indicators Hospital
  Service Volumes

August 2007
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Overview

• This session covers Patient Access Outcomes
  service volumes indicators in 2008-10 Hospital
  Annual Planning Submission (HAPS) Guidelines and
  Web-Enabled Reporting System (WERS)
• Aimed at hospital and LHIN staff involved in the
  preparation and review of HAPS
• Updated and expanded as needed

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2008-10 HAPS/HSAA Indicators Domains
Training Development
Financial Health
Organizational Health
Capital Health IT/Med Equipment
Turnover Rate
Paid Sick Time (Full-time)
Operational Efficiency
Vacancy Rate
Paid Overtime (Full-time Part-Time)
Capital Health Facility Condition Index
Nursing FTE
Current Ratio Consolidated
Staff Satisfaction
Total Margin Sector Code 1
Workplace Safety Indicators
Total Margin Consolidated
Readmissions to Own Facility
Readmissions (All Facilities CHF Only)
CCC Skin Ulcers
Mental Health
CCC Care Index Indicators
ALC Indicators
Volumes
Rehab Indicators
ED Indicators
Stroke Care Index Indicators
Patient Safety
Hospital-CCAC Integration Indicators
System Integration
Patient Access Outcomes
HSMR
Adult IP Sat Indicators
ED Sat Indicators
Paediatric Sat Indicators
Patient Experience
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2008/10 HAPS/H-SAA Patient Access Outcomes
(PAO) Volumes Indicators

• Performance Indicators
• Total Acute Activity, including Inpatient and Day
  Surgery Weighted Cases
• Mental Health Inpatient Days
• ELDCAP
• Rehabilitation Inpatient Days
• CCC RUG-Weighted Patient Days
• Ambulatory Care Visits
• Emergency Visits

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Monitoring Volumes Indicators CMG, Plx, PAC-10

• JPPC Acute Care Advisory Group established in Jan
  2007 to conduct comprehensive assessment of the
  new CIHI Case Mix Groups (CMG) Grouper and
  associated weights on current funding models and
  H-SAA indicators
• During transition and evaluation period, CIHI
  Case Mix Group (CMG)/Plx methodology and MOHLTC
  PAC-10 weights will continue to be used to
  calculate acute inpatient weighted cases.
• These data will be used for all H-SAA indicators
  that rely on acute inpatient weighted cases
  information.

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Monitoring Volumes Indicators CMG, Plx, PAC-10
Since hospitals are currently collecting acute
care inpatient data using CMG via their vendor
abstracting systems, MOHLTC and CIHI have
developed a transition plan to assist hospitals
during this transition and evaluation
phase Starting in October and continuing on a
monthly basis, CIHI will produce hospital
specific CMG/Plx files for all Ontario acute care
inpatient data, which will be securely posted to
its website. After downloading the monthly file,
hospitals will then be able to use the PAC-10
calculators found on the FIM website
(www.mohltcfim.com) to assign PAC-10 weights to
their data. In addition, the MOHLTC has developed
a SAS version of the CMG/Plx grouping methodology
for those hospitals that are interested in using
a tool to group their data. For more information
regarding the CMG and CMG/Plx transition plan,
please visit www.mohltcfim.com/cms/upload/news/0/C
MG_Transition_Plan.pdf
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Performance Indicator Total Acute Activity

• Data Sources
• Discharge Abstract Database (DAD) and the
  National Ambulatory Care Reporting System (NACRS)
  
• Inclusions
• Includes both inpatient day surgery volumes
• Exclusions
• Excludes inpatient surgery volumes reported under
  the 712 functional centres, but also reported in
  the Discharge Abstract database (DAD).

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Performance Indicator Total Acute Activity

• Effective 2007/08 Q3, Day Surgery 7134020
  functional centre is no longer mandated for NACRS
• It is RENAMED to Day/Night Care Pre Post
  Operative Care (excluding OR/RR)
• Rationale this unit provides pre- and
  post-operative care only.
• Pre and post surgical care does not initiate a
  NACRS abstract.
• NACRS day surgery cases previously reported in FC
  7134020 should be reported in functional centre
  71260 or 7134025 depending on where the
  activity is occurring.

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Performance Indicator Total Acute Activity,
including Inpatient Day Surgery

• In order to calculate DS equivalent weighted
  cases (EWC) OCDM
• DS FY0607 equivalency should be used
• DS EWC DS CACS weights DS FY0607 equivalency
• Information on how to calculate IP PAC10 weights
• "PAC-10 Calculator for 2006/07"
• http//www.mohltcfim.com/cms/upload/a_10349/Pac10-
  2007Calculator.xls
• Total IP and DS EWC IP PAC10 DS EWC

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Performance Indicator Corridors Total Acute
Activity, including Inpatient Day Surgery
The table below shows the Performance Corridor
boundaries by Hospital size for inpatient and day
surgery activity as measured by weighted cases.
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Performance Indicator Mental Health Inpatient
Days

• Mental Health Inpatient Days are reported in the
  Ontario Health Reporting Standards (OHRS) under
  the following account codes
• OHRS primary account codes are
• 7127625, 7127645, 7127650, 7127655, 7127690,
  7127695
• OHRS secondary statistical account codes are
• 403
• Reported volumes should be for designated mental
  health beds

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Performance Indicator Corridors Mental Health
Inpatient Days
Below are the corridor floors for this indicator
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Performance Indicator Corridor ELDCAP

• Data are reported in the OHRS
• OHRS primary account codes are
• 7129560
• OHRS secondary statistical account codes are
• 403
• Reported volumes should be for designated
• ELDCAP beds
• For all hospitals, the corridor is between 98
• and 102

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Performance Indicator Corridors Rehabilitation
Inpatient Days

• Data are reported in the OHRS as Rehabilitation
  Inpatient Days
• OHRS primary account codes are
• 71281
• OHRS secondary statistical account codes
• 403
• Reported volumes should be for designated
  rehabilitation beds
• The corridor floors are below

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Performance Indicator Corridors CCC
RUG-Weighted Patient Days

• Based upon the CIHI Chronic Care Reporting System
  (CCRS)/Resource Utilization Group (RUG-III)
  weighted patient days (RWPD)
• Below are the corridors of performance

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Performance Indicator Ambulatory Care Visits

• Reported in the OHRS as
• Total Ambulatory Visits excluding
• Emergency Visits (all scheduled,
  non-scheduled, inpatient (IP) and outpatient (OP)
  clinic visits, and visits in surgical Day / Night
  functional centres).
• OHRS primary account codes are
• 7134 (excluding 7134025, 7134055), 712, 7135,
  715
• OHRS secondary statistical account codes are
• 450, 5, (excluding 50, 511, 512, 513,
  514, 518, 519, 521)

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Performance Indicator Corridor Ambulatory Care
Visits

• Below are corridor floors.

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Performance Indicator Corridors Emergency
Visits

• Data reported in the OHRS as Emergency Visits
• All scheduled, non-scheduled, IP and OP visits in
  Emergency functional
• centres
• OHRS primary account codes are
• 71310
• OHRS secondary statistical account codes
• 450, 5, (excluding 50, 511, 512, 513, 514,
  518, 519, 521)
• Below are the corridor floors

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More Information

• Other e-learning modules and background materials
  in this series are posted on www.oha.com, with
  links on WERS, FIM, LHIN and JPPC websites
• If you have questions, please contact your local
  LHIN www.lhins.on.ca

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We Welcome Your Feedback

• For more information on this e-learning series or
  other initiatives of the LHIN-JPPC Communication
  Education Work Group please contact
• Mimi Lowi-Young, Chair
• c/o Ontario Joint Policy and Planning Committee
  (JPPC)
• 415 Yonge Street, Suite 1200
• Toronto, ON M5B 2E7
• Tel [phone] Fax [phone]
• www.jppc.org