Our fifth yearly report shows that there have been some modest improvements in quality across Ontario’s health system, there is room for more improvement, and there are examples of higher performance that could be applied more broadly. Our top-line findings underscore areas of concern that are of critical importance to us all: wait times; the accuracy and completeness of medical information; chronic disease management; access to primary care; and patient safety.

This year’s report also includes new information about how to stay healthy and safe in long-term care, greater analysis of hospital infections, maternal and child health, and enhanced coverage of mental health care.

Here is an overview of our main findings:

• There are serious problems with how patients move through the healthcare system, from the emergency department to hospital and long-term care. Patients wait too long and the system is wasting resources.
• There have been solid improvements in cardiovascular care. Heart attack incidence, mortality and readmissions are declining. More patients with heart attacks are filling prescriptions for the right medications, including cholesterol-lowering drugs, beta-blockers and angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs).
• Wait times are good for cataract and cardiovascular surgeries and have improved for hip and knee replacements, but there is still room to do better. The largest area for improvement is urgent (priority 2) cases for all surgeries; for example, only 53 percent of urgent cancer surgeries are done within the recommended timeframe. CT/MRI scan waits are still too long with only one-third of MRI scans being done on time despite having doubled the number of scans in the last six years.
• We have also seen cautious signs of improvement in care for diabetes and other chronic diseases. Further improvements to chronic disease management require improved engagement of patients and better coordination and communication among providers. 
• Ontario has made significant improvements in use of information technology, particularly in doctors’ use of electronic medical records (EMR). The proportion of family doctors who have an EMR system has risen from 26 percent in 2007 to 43 percent in 2009. This represents important progress in a short period of time. However, we still lag behind countries such as the UK, Australia and the Netherlands, where 95 to 99 percent of family doctors have an EMR system.
• About 7.1 percent of adult Ontarians (aged 18 and over)continue not to have a family doctor; that’s roughly 730,000 people. About half are actively looking for one. Almost nine in 10 Ontarians say they are waiting too long to see their doctor, an indicator that has gotten worse in the last three years. 
• Progress has been stalled for three years in reducing unhealthy lifestyle activities, including smoking, heavy drinking, and physical inactivity. Strategies must be tailored for vulnerable populations with low income or low education, who have a higher risk of having unhealthy lifestyles and who face unique challenges. 
• C difficile infection rates have been decreasing gradually over the past year. However, handwashing rates are still far too low — only 53% at the moment just before a health professional sees a patient. Infections such as ventilator-associated pneumonia and central line infections continue to occur in our hospitals. These infections are associated with high mortality rates, and yet many leading institutions in North America and even here in Ontario have eliminated them through adherence to infection control practices.
  

For more information, read the Introduction and Summaries section of the report, or read the full report. The summaries offer a snapshot of key findings for hospitals, long-term care, home care and primary care, as well as brief summaries for cardiovascular disease, diabetes, mental health and cancer. Each summary includes questions to ask of leaders or caregivers for self-reflection.

This year, LHIN Analyses of key differences for each local health integration network (LHIN) are also available.

Success Stories

Our report identifies local stories of improvement. These success stories are closely linked to the key findings of the report, demonstrating that improvement is possible.

Emergency department wait times at Credit Valley Hospital

Primary care at Athens District Family Health Team

Chronic disease management at New Vision Family Health Team

Readmissions at North York General Hospital

Hospital infections

Reducing falls in long-term care

Managing alternate level of care (ALC) at Trillium Health Centre

Worker’s health at Oakville Trafalgar Memorial Hospital

Mental health case management in Thunder Bay

 

Once you’ve read our report, please take a few minutes to complete our survey.

Please click here for our technical appendix, the 2010 Quality Monitor Indicator Database (QMID)

 

2010 Report:

OHQC 2010 Yearly Report

OHQC 2010 Report -- Introduction and Summaries

OHQC 2010 Report -- LHIN Analyses