How we measure up

Being accountable to our patients and community is essential to earning your trust and building an international reputation for excellence. "Accountability" means making the right clinical and managerial decisions, managing resources efficiently and measuring our performance against provincial and national benchmarks.

What are "benchmarks"?
A "benchmark" is a standard by which we measure our performance and compare ourselves against others. Benchmarks may be based on data that is collected nation-wide, province-wide and/or from a specific set of our peer hospitals.

What is a wait time?
A wait time is how long a patient waits for a particular service, treatment or procedure. For example, one wait time is the number of days a patient waits to see a specialist at UHN after being referred from his/her family physician. Another wait time is the number of hours a patient waits to be admitted to a nursing unit after being seen in the ER.

How do we measure wait times?
In most cases, the wait time start and end points are defined and collected, either electronically or manually, and we measure the average wait time. In other cases, a critical limit is set and we measure the number of cases that fall outside the limit.

Why are some wait times longer than others?
Three factors affect wait times at UHN's hospitals:

1. Availability of resources – this could include inpatient beds, operating room space, staff and equipment resources.
2. Client demand – a high demand could be caused by a lack of services elsewhere, preference for UHN’s specialized services or simply a large number of patients requiring the same service.
3. Urgency – it isn't always possible to treat patients on a "first-come first-serve" basis. Depending on the urgency of the case, a patient may wait a shorter or longer time for the same service.

What are we doing to improve wait times?
By regularly measuring and monitoring our wait times, we are able to identify problem areas quickly and address their root causes. We are striving to achieve efficient service while maintaining the highest possible standard of care. There is a need to assess the system as a whole to ensure that needed resources are available at UHN as well as other healthcare facilities.

The "Balanced Scorecard"
The Balanced Scorecard provides measures that describe the critical aspects of the organization. It provides a framework for all levels of management within the organization and gives you a snapshot of how our hospitals are performing in critical areas.

We've broken the scorecard into five key areas:

• Client and Community Focus - how do our patients and community view the performance of our hospitals? We measure this primarily through inpatient, emergency and outpatient satisfaction surveys.
• System Competency - are we producing appropriate outcomes? This includes a variety of measures, such as mortality rates, infection rates, length of stay measures, alternative level of care days and readmission rates.
• Financial Performance and Condition - are we using our resources efficiently and effectively? The primary measure for this is the cost per weighted case.
• Responsiveness - is access to care available in a timely manner? This is monitored using various wait time measures across UHN.
• Work life - how do our staff view the performance of our hospitals? This is measured using employee opinion surveys, staff turnover rates, sick hours and overtime hours.

With the right data and analysis, we are finding ways to reduce Emergency wait times, improve the efficiency of labs and lower the rates of post-operative wound infections and re-admissions. In the long run, good management of our services and resources allows us to focus on our primary role — providing patients with the highest possible standard of care.

With this goal in mind, we've compiled a list of key definitions and statistics to help you understand how we measure things like wait times, patient satisfaction and the costs of providing care.

Some of the factors we look at on a regular basis include:
Current Wait Times	» the time it takes between being referred to a UHN clinic/specialist and receiving treatment/consultation.
ER Ambulance Drop-offs	» the number of patients dropped off by ambulance to our emergency departments each month.
ER Satisfaction	» how patients in our Emergency perceive both the quality of care and provision of services they receive.
IP Satisfaction	» how patients perceive both the quality of care and provision of services they receive at UHN.
OR Surgical Cancellations	» the number of OR cases cancelled within 48 hours of the scheduled surgery due to avoidable factors.
Patient Complaints	» patients dissatisfaction with the care and services received during their stay at our hospitals.
Patient Compliments	» patients satisfaction with the care and services received during their stay at a our hospitals.
Readmission Surgical Wound Infections	» the number of surgical patients who are readmitted to our hospitals Emergency after being discharged.
Wait Times for CT Scan	» the time it takes between requesting an appointment and receiving an appointment for a CT scan.
Wait Times for MRI	» the time it takes between requesting an appointment and receiving an appointment for an MRI.

For more information, view all UHN Performance Measures.

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