The GTA-OBS dashboard is comprised of specific quality of care indicators that were chosen by member hospitals as important indicators of quality of care. These indicators are not meant to override the importance of the Provincial dashboards, but perhaps to enhance them and provide quality of care indicators that Network members feel are appropriate in this particular region.
It is important to realize that any dashboard of quality of care, despite its name, may in fact not reflect the actual quality of care delivered in any specific case or in any individual hospital. There are many variables, for example, that can affect the admission of a term infant to the NICU, some of which might have to do with health policy or management in a particular hospital rather than the quality of care imparted to the woman or her infant. We see this dashboard as the beginning, or first look, at what is happening to our patient with respect to important outcomes in the GTA. They will serve as the starting point for a closer look in certain areas, such as the GTA-OBS initiative on postpartum hemorrhage reduction, for example.
In many instances, it is difficult to look at a quality-of-care indicator without considering what we are ultimately trying to achieve - a healthy outcome for mother and baby. For example, we still do not know what the optimal Cesarean section rate should be to provide optimal outcomes in 2015.
However, the dashboard does provide partner hospitals with a bird’s eye glance of comparative hospitals and comparative outcomes which we hope will be the driving force behind quality improvement projects.
A disclaimer: some of the data in the BORN database may not have been validated and further work is in process in this area. Nevertheless, we feel it is an important start and further dashboard updates will allow hospitals to embark upon projects themselves or as part of the Network.
You will see that hospitals are anonymized and the identity of each is only known to BORN and each individual hospital. It will stay that way unless all partner hospitals get permission for this data to be de-anonymized. We think the time has passed in which physicians practice without outcomes - we should embrace the opportunity to work together towards transparency and the improvement of the quality of care of our patients.