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Sunnybrook responds to CIHI report

September 18, 2014

The Canadian Institute for Health Information (CIHI) has posted on its website a set of 15 indicators measuring the performance of hospitals across the country. We are supportive of public report cards such as this, which offer an opportunity to look at the organization's performance in specific areas and determine where there may be opportunities for improvement.

However, it is important to use these data summaries as indicators and not to look at them as rating systems. Each hospital cares for unique patient populations and it can be difficult to draw comparisons across institutions.

As the largest single site source of critical care in the country, it would stand to reason that we see some of the most critically ill and injured patients in the province, which will cause results to appear below average when trying to make comparisons with other institutions.

It is important to keep these issues in mind when looking at the data released today. For more information, we invite you to watch the following videos of Sunnybrook leaders addressing individual indicators mentioned in the CIHI report.

Dr. Andy Smith responds to the CIHI report:

More information about individual indicators:

In-hospital mortality following major surgery (within 30-days):

Low-risk Caesarean and obstetrical readmission (within 30-days):

Physician initial assessment in emergency department:

In-hospital sepsis:

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About Sunnybrook

Sunnybrook Health Sciences Centre is Canada's largest single-site hospital and home to the country's largest critical care unit. With the country's busiest trauma centre and regional centres for stroke, cardiac care and cancer, we care for many of the sickest patients in the region.

This makes it hard to compare our patient outcomes with other hospitals.

1.2 million patients visits/year

Leader in cardiac care

Busiest trauma centre

Hospital Report Cards

Sunnybrook is supportive of public report cards such as the recent Canadian Institute for Health Information (CIHI) report. These reports offer an opportunity to look at the organization’s performance in specific areas and determine where there may be opportunities for improvement. Find more information below about 5 of the 15 indicators in the CIHI report.

Caring for Moms and Babies

About our program: We are a tertiary high-risk referral centre, which means the highest-risk moms, and the tiniest and sickest babies come to Sunnybrook for care.

Re-admission rates: Sometimes, moms-to-be are admitted into hospital so we can check on their complications, and then they are discharged home to be comfortable while they wait for their baby or babies. They then come back to deliver.

C-Sections: It is hard to compare the number of c-sections because Sunnybrook receives the greatest number of in-utero transfers requiring urgent care.

In-hospital mortality following major surgery (within 30-days)

3.0% mortality rate in 2010/2011 decreased to 2.4% mortality rate in 2012-2013.

A decrease in mortality rate has occurred in spite of a surgical population that is increasing in complexity. For example, patients are older and have many health issues at the time of surgery.

Emergency Room Wait Times

This indicator measures the time interval between the earlier of triage date/time or registration date/time and the date/time of physician initial assessment in the emergency department (ED)

We are home to the country’s largest trauma centre and a number of other regional programs that care for urgent conditions such as stroke and cardiac disease.

Our patients are some of the most complex and acutely ill or injured in the country.

Those who visit our ED with non-life threatening health concerns may wait longer for care than they would in another hospital ED.

Sunnybrook's admission rate is almost 25%, almost double that of our peer hospitals, due to the serious cases that come to us for emergency care. Admitting patients takes more time, which makes it difficult for less acutely patients to be seen in a timely manner. We have a number of initiatives aimed at improving this.

In hospital sepsis

Sepsis is a blood infection. Sunnybrook has a strict protocol in place within the Emergency Department for patients who arrive with signs of Sepsis in order to treat these patients quickly.

In examining the data, our unadjusted results for 2013-14 demonstrate a decrease in sepsis rates over previous years, including the years represented in the CIHI data.

Ventilator Associated Pneumonia and Urinary Tract Infections (UTI) are the most common causes of sepsis. Because of our large number of critical care beds, we have a high number of patients who require ventilators and therefore a greater risk of sepsis. UTIs are associated with catheterization. We have also established a new program for nurse-initiated catheter removal in order to reduce the number of catheter days on some units.

Dr. Andy Smith