Electronic health records (EHRs) offer the opportunity to improve patient outcomes across the continuum of care. Fundamental to achieving these improvements is the use of standardized clinical data to measure and compare clinical outcomes across care settings. The Canadian Health Outcomes for Better Information and Care (C-HOBIC) encompasses a suite of standardized outcomes including: a) functional status, b) symptom management (dyspnea, nausea, pain, fatigue), c) continence, d) risk for falls and skin breakdown, and e) readiness for discharge. The acute care admission and discharge assessments of these outcomes has been captured numerically and graphically in a Transition Synoptic Report (TSR) designed for sharing with clinicians in post-acute discharge sectors. The TSR provides a summary of the acute care admission and discharge C-HOBIC information. By comparing the clinical outcomes between admission and discharge, health care providers (HCPs) can plan for appropriate care and the resources needed for ongoing patient care. The components of these evaluation efforts included online surveys, focus groups, and senior nursing leader interviews. The evaluation questions focused on their perceptions of the C-HOBIC measures and TSR usability, utility and value to clinical practice. Evaluations have been conducted to understand clinician use and perceptions of the impact and value of the outcome measures and a TSR. In this presentation, the results of the evaluations and recommendations for future directions will be provided.
Evaluations have been completed in 2 provincial jurisdictions, specifically engaging acute care and home care clinicians. In this presentation, the C-HOBIC and TSR post-implementation evaluation findings will be presented and discussed. Implications for future implementations of C-HOBIC and the TSR will be addressed.
The importance of adopting clinical data standards to facilitate the consistent measuring, monitoring, and reporting of clinical outcomes cannot be underestimated. Standardizing patient assessments within and between care settings has the potential to demonstrate the collective impact of various providers, interventions, and supports on patient outcomes, system costs, and overall use of the healthcare system. The value of using a graphic and numeric representation to share clinical outcomes in the form of a TSR between care settings is yet to be fully understood. Our initial implementation and evaluation activities provide insights to inform future use.
This initiative was sponsored and managed by the Canadian Nurses Association, and funded with contributions from Canada Health Infoway and participating provincial partners.