Purpose of the Site

This site provides information on key areas where long-term care homes are measuring quality. The main purpose of the site is to encourage residents, families and staff in homes to discuss this information together and work cooperatively on ideas to improve quality. (Click here for suggested questions that residents and families can ask at their homes)

Because data are not available on all homes yet, we do not recommend that you use the site at this time to help choose a home. By the end of 2011, when all homes are reporting data, this site could help you make an informed choice about a long-term care home. Families should however, consider other sources of information when making a decision about a home (see Tips & Resources).

Where the Data Comes From

Most of the data comes from a new data collection tool, the RAI-MDS (Resident Assessment Instrument – Minimum Data Set). This standardized tool is now used in most Canadian provinces and many other countries around the world. The Ministry of Health and Long-Term Care is currently working with homes to implement RAI-MDS across the province. Under the system, every resident undergoes a detailed assessment of their health, at least once every three months. This assessment is conducted by a staff member at the home specially-trained to collect this information.

We also use provincial databases about access, emergency department visits and drug use, and data from a resident satisfaction survey from a sample of 30 homes conducted by researchers at the University of Toronto. For this study, in-person interviews were conducted with 60 randomly selected eligible residents (willing to participate, no severe dementia) by trained interviewers independent of the long-term care home. Planning is underway to implement resident and family satisfaction surveys for all homes over the next two years.

Indicators Used for Public Reporting

Indicators used for public reporting for long-term care were selected following a rigorous and evidence-based process which included:

• an environmental scan of long-term care indicators in use in Ontario and other jurisdictions and public reporting mechanisms;
• consultations with academic experts (Scientific Panel); and
• consultations with representatives from the People Caring for People Implementation Team, led by Shirlee Sharkey, President and CEO of Saint Elizabeth Health Care and author of the People Caring for People report.
  

These groups chose indicators that can be accurately measured and influenced by homes. Please click here to read the Report of the Long Term Care Scientific Expert Panel.

Indicators are organized into the OHQC’s nine attributes: accessible, effective, safe, patient (resident)-centred, equitable, efficient, appropriately resourced, integrated, population health. Currently, we report on accessible, effective, safe, patient (resident)-centred, and appropriately resourced. We will build on this as the site develops. For more information about the OHQC attributes click here: http://www.ohqc.ca/en/framework.php.

Limitations of the Data

Provincial results are based on data from 217 eligible long-term care homes (homes on the RAI-MDS system). This is only a partial sample of homes in Ontario. All homes will be included in provincial results in 2011.


Homes Participating in Public Reporting

This site looks at long-term care homes funded and regulated by the Ministry of Health and Long-Term Care. These homes care for people who are no longer able to live independently or who require onsite nursing care, 24-hour supervision or personal support. They include:

• Nursing homes -- for-profit and not-for profit corporations;
• Municipal homes for the aged – owned by local councils; and
• Charitable homes – owned by non-profit corporations, such as faith, community, or cultural groups.
  

Retirement homes are not regulated or funded by the Ministry of Health and Long-Term Care and are not being publicly reported.

At this time, participation in public reporting by long-term care homes is voluntary, and only those homes that have been using RAI-MDS (Resident Assessment Instrument – Minimum Data Set) for at least a year have been invited to post their results. The majority of homes do not have enough data yet to qualify. More homes will be added over time and by the end of 2011, all 623 homes in Ontario will be reporting.

2011: The Site at a Glance

Over the next two years, more homes will be added and more indicators of quality will be reported by homes.

By the end of 2011, you will see:

• Results for each of Ontario’s 623 long-term care homes
• More results from resident & family satisfaction
• More frequent updates (every three months)
• Trends over time (to see if quality is improving)
• Comparisons with other provinces and countries
  

We will also aim to identify homes around the world who have the best results and highlight what they have done to achieve them. This information will help homes set targets for quality improvement.

Acknowledgements

The OHQC thanks the Canadian Institute for Health Information (CIHI) for providing the data for public reporting and the following organizations for their input in designing and testing this website:

• Concerned Friends of Ontario Citizens in Care Facilities
• Ontario Association of Residents’ Councils
• Ontario Family Councils’ Program
• Ontario Long-Term Care Association (OLTCA)
• Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS)
  

We would also like to recognize the following members of the OHQC Long-Term Care Reporting Scientific Expert Panel for their guidance in identifying and developing measures of quality and members of the People Caring for People Implementation Team.

Scientific  Expert Panel
Geoff Anderson, MMD, PhD, University of Toronto
Andrea Baumann, MScN, PhD, McMaster University
Katherine Berg, MSc, PhD, , University of Toronto
Arlene Bierman, MD, MS, FRCPC, University of Toronto
Larry Chambers, PhD, PACE, Hon FFPH University of Ottawa
Ben Chan, MD, MPH, MPA, Panel Chair and CEO, Ontario Health Quality Council
John Hirdes, MA, PhD, University of Waterloo
Vince Mor, PhD, MED, Brown University John Morris, PhD, Harvard University
Gary Naglie, MD, MSc, University of Toronto
Dorothy Pringle, RNMS, PhD University of Toronto
Paula Rochon, MD, MPH, FRCPC, Women’s College Research Institute
Gary Teare, MSc, PhD, D.V.M Saskatchewan Health Quality
Walter Wodchis, MA, MAE, PhD, University of Toronto

People Caring for People Implementation Team  

Shirlee Sharkey – Chair
Maureen Hutchinson, Ontario Association of Residents Councils
Robert Gadsby, Family Councils' Program 
Sheldon Wolfson, Ontario Association of Non-Profit Homes and Services for Seniors
Candace Chartier, Ontario Long-Term Care Association
Candace Rennick, Canadian Association of Public Employees
Beverly Mathers, Ontario Nurses’ Association
Deborah Hammons, Local Health Integration Networks (LHINs)
Pat Stoddart, LHINs
Debra Bell, Ministry of Health and Long-Term Care