Performance Measures

In 2008, Accreditation Canada introduced six patient safety performance measures into the Qmentum accreditation program in the areas of patient safety culture survey, medication reconciliation admission, health care associated infection, and surgical site infection.

Core patient safety performance measures were selected based on:

• Literature review and environmental scan
• Input from Accreditation Canada Patient Safety Advisory Committee and key contacts
• Feedback from client organizations through Accreditation Canada National Consensus Survey
• Accreditation Canada requirements for performance measures
• Alignment with other key initiatives in healthcare performance measurement

Accreditation Canada pilot tested the core set of Patient Safety performance measures in 2007 at accredited organizations located across the country that represented the continuum of care.

Patient safety culture was identified as key for establishing a health care environment focused on safety. To measure safety culture, organizations administer a patient safety culture survey to their staff; the Modified Stanford instrument (Version 2007) is currently being used, based on the latest research out of York University

Risk to patients is highest at transitions of care, in particular the risk of medication errors.
To measure the proportion of individuals receiving medication reconciliation at admission, organizations collect one performance indicator: the percentage of admitted patients receiving medication reconciliation.

Post surgical infections are recognized as a significant risk and health burden to the individuals receiving care and the health care organization. To measure surgical site infection, organizations collect two performance indicators: rate of post surgical infections and rate of timely administration of prophylactic antibiotic.