Abstract
BackgroundIn the past decade the provision of home care services in Canada has doubled; with this increase there has been a growing interest in improving quality and safety. National-level data are captured in the Home Care Reporting System (HCRS), using the interRAI-HC tools. Data in the HCRS provide decision-makers and administrators with actionable evidence to inform quality and safety improvement initiatives. The objective of this study was to determine how providers and administrators were using these data, and if there were any opportunities to enhance their use.MethodsWe collaborated with the Canadian Patient Safety Institute to conduct this qualitative study. To understand data use in home care, we recruited participants in management and/or data analysis roles from home care organizations across Canada. We conducted three individual interviews and three focus group interviews with a total of eleven participants from five Canadian provinces. Individual and focus group interviews were audio recorded, transcribed, and analysed using a combination of emergent coding and thematic analysis.ResultsSeveral participants provided powerful examples of how interRAI data have been used to guide patient safety and quality improvement initiatives; however, all participants recognized challenges in using these data. Leveraging interRAI data in the complex home care environment is limited by several factors: the general “newness” of these data in many jurisdictions; the sheer volume of data; limited capacity and resources to interpret and analyse the data; and connectivity issues in rural areas. Participants recognized and appreciated the training that has been provided, and made several recommendations for additional training.ConclusionsMandated clinical datasets, such as the suite of interRAI tools, have the potential to improve quality and inform decision-making. However, in order to utilize these data, home care agencies require additional education, personnel and supports. Additional training and resources for these organizations could improve the use of available data by home care agencies, as well as outcomes for individuals receiving home care services.
Highlights
In the past decade the provision of home care services in Canada has doubled; with this increase there has been a growing interest in improving quality and safety
Participants discussed overseeing the implementation of RAI tools, providing structure and support for home care projects, understanding the data reports generated, and supervising quality improvement initiatives
The RAI data that are reported back to organizations give them a clear picture of how their organization is doing compared to others in their region: The information that we get from interRAI Canada is that they give us our [organization’s] data but they compare it, other home care providers, generic as a whole
Summary
In the past decade the provision of home care services in Canada has doubled; with this increase there has been a growing interest in improving quality and safety. Home care has been cited as a preferable method of care delivery for individuals with chronic, palliative, or rehabilitative needs due to the sense of retained independence and familiarity [1]. This preference, coupled with rising health care costs, has led to a push to reduce long term care (LTC) and acute care admissions, and increase home care service provision to more efficiently utilize the limited healthcare resources in Canada [2]. The provision of home care services has doubled, and this growth is projected to continue with the aging population [3]
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