The following is a case study completed by an independent consultant regarding implementation of how2trak in the NSM CCAC
Improved Client Outcomes, Better Use of Resources
and Operational Savings: The Situation: A Need for Data to Understand Opportunities for Improvement
Debbie Roberts is the Senior
Director of Performance
Management and
Accountability for the North
Simcoe Muskoka Community
Care Access Centre
(NSMCCAC). Responsible for
the quality of care
delivered within a large
geography, Debbie is
familiar with the challenges
of balancing optimal client
outcomes with the realities
of tight home care budgets.
For the past year she has
been engaged in a mission to
use data to optimize
resource allocation, both in
terms of her staff and the
materials they use on a
daily basis.
After attempting an analysis
of nursing practices across
all agencies in her region,
Debbie made two important
discoveries. It was clear
that NSMCCAC was using more
nursing services than the
rest of Ontario, and even
among NSMCCAC’s own
agencies, nursing services
were utilized differently.
Analysis of the existing
client database could not
explain, however, the
rationale for utilizing
nursing resources, nor could
the impact of nursing care
on patient outcomes be
consistently measured.
The Solution: An
Evidence-based Analysis
System for Decision Making
Debbie attended a session at
a Toronto Central CCAC
Conference focused on
improving the efficiencies
and effectiveness of wound
care. Wound care accounts
for approximately 50% of
homecare visits, and is a
significant overall cost
component. The session
reported on results achieved
with how2trak, a
comprehensive database
analysis system from Health
Outcomes Worldwide (HOW).
The results reported showed
both improved clinical
outcomes (effectiveness of
care) and reduce costs
(efficiency of care)
achieved by using how2trak
reporting.
About a year ago, Debbie and
her team adopted the
how2trak system and now use
it in conjunction with their
own Lean Six Sigma
operational processes. “In
order to be successful in
achieving our effectiveness
and efficiency objectives
for the wound care program,
we needed a data tool that
would provide consistent and
on-going inputs that would
allow us to measure and
track our progress. The
how2trak system was the
answer for us” says Debbie.
When the team started
analyzing data from the
how2trak reports, it
revealed two important care
trends: a high utilization
of dry dressings for
surgical wounds, and a daily
wound care nursing visit
rate of 30%. “Clinical best
practice in surgical wound
care is to use moist
dressings, and we could now
share our own practice data
to refresh our staff
education. As well, when
measured against a national
standard rate of 15-20%
daily visits for surgical
wound care, we now knew that
we had an opportunity to
improve how we were managing
our surgical wound clients.”
The team set objectives to
improve surgical wound
client outcomes and to
reduce daily client visits
to the 15-20% national rate.
The Results & Benefits:
“The results that we have
achieved are well beyond our
expectations. Our daily
nursing surgical wound care
visits are down to just 4%,
and our clients are healing
faster”, says Debbie.
Reducing the daily visit
rate from 30% to 4 % has
yielded hard dollar savings
of $60 per client visit, in
addition to significant
costs saved through reduced
dressing materials used.
The benefits are very real.
Says Debbie, “For many years
we have had a long waiting
list of clients waiting to
access our personal support
line. Sometimes the wait
time was upwards of 300
days. By reallocating
resources to this important
component of care
management, our team has
been able to reduce the
number of personal support
line clients waiting from
850 to 300 – a 65%
reduction! We have also seen
more dialogue between nurses
and client care
coordinators, and important
collaboration in care
delivery.”
The Partnership
In any technology
implementation, having a
flexible, responsive partner
to develop reports that meet
the agency’s needs is a
critical consideration.
“Corrine (McIsaac, CEO of
HOW) and her team have been
great to work with, are
always willing to listen and
respond to what we need.
They helped us to link
how2trak with our own
database and analytical
tools, which helped us
customize our caseload and
related patient outcome
tracking.” Says Debbie. This
allowed the team to capture
and compare important data
related to healing rates and
client days in service.
Future Plans
In terms of the future for
the how2trak system, Debbie
would like to eventually
move to real-time data
entry. “We are only
scratching the surface as it
relates to the potential for
the how2trak data to improve
how we operate” says Debbie,
and points to plans for a
regional initiative to
undertake a prevalence study
that will use how2trak data
to ‘follow the client’ and
measure longer-term
outcomes, a difficult task
when working with multiple
distinct hospital
organizations.
