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Home » Research » Community Health Assessment » 2004 Community Health Assessm…

2004 Community Health Assessment Report

The 2004 Community Health Assessment Report provides a portrait of the health and well-being of residents living in the Winnipeg Health Region. This Report builds a foundation of information to support evidence based planning and decision making.

Volume I – Executive Summary

Highlights findings from the Population Health Profiles and the Data Book.

Volume II – Population Health Profiles

A report on health outcomes and determinants of health for various population subsets in the WHR. These populations include the 12 community areas (CAs) that comprise the WHR, and populations of special interest.

Background

Methods

Profiles

Community Areas

Population Subsets (Special Interest / Priority / Vulnerable)

Appendices

Volume III – Data Book

A compendium of indicators that measure health status, determinants of health, health system performance, and population and health system characteristics.

Background

Methods

Indicators – Health Status & Determinants of Health & Well-Being

Characteristics of a population and its health state. Population characteristics include ethnicity and culture, personal behaviour and lifestyle, as well as living and working conditions that will typically effect health states. Measures of health status include life expectancy, disease prevalence, potential years lost due to disease or injury, as well as self-reported ratings on well-being.

Health Status - Length of Life

Life expectancy and disability-free life expectancy.

Life Expectancy at Birth

Life Expectancy at 65 Years

Disability-free Life Expectancy

Health Status - Ability to Function

Levels of human function associated with the consequences of disease, disorders, injury and other health conditions. This includes measures of disability and daily function.

Two Week Disability Days

Proportion of Population that has Limits to their Daily Function

Health Status - Well Being

Broad measures of physical, mental and social well-being of individuals.

Self-rated Health

Functional Health

Self-Esteem

Life Stress

Determinants of Health & Well Being - Environmental Factors
Determinants of Health & Well Being - Healthy Child Development

Early experiences affecting brain development and health in later life. Includes school readiness. The physical, social, mental, emotional and spiritual development of children and youth are affected by the other determinants of health.

Congenital Anomalies

High Birth Weight

Low Birth Weight

Pre-term Birth Rate

Breastfeeding Practices – Initiation

Breastfeeding Practices – Duration

Childhood Immunization: Immunization Coverage for 1, 2, and 7 Year Olds

Childhood Immunization: Hepatitis B Immunization for Grade 4 Students (Pending)

Children and Youth Injury Death

Child-Youth Injury Hospitalization

Childhood Asthma Rates

Youth Health Education Workshops

Determinants of Health & Well Being - Biology & Genetics

The basic biology and organic make-up of the human body are a fundamental determinant of health. In some circumstances, genetic endowment appears to predispose certain individuals to particular disease or health problems.

Biology & Genetics

Determinants of Health & Well Being - Culture

Some persons or groups may face additional health risks due to a socio-economic environment that is largely determined by dominant cultural values that contribute to the perpetuation of conditions such as marginalization, stigmatization, loss or devaluation of language and culture and lack of access to culturally appropriate heath care and services.

Ethnic Origin

Determinants of Health & Well Being - Gender

Gender refers to the array of society-determined roles, personality traits, attitudes, behaviours, values, relative power & influence that society ascribes to the two sexes on a differential basis. Factors to consider are comparison of PYLL between men and women, depression rates between the genders, mortality rates for specific conditions (cancer, heart disease) between men and women, hiring policy related to affirmative.

Gender

Determinants of Health & Well Being - Social Environments

Safety in the community and criminal activity can affect other determinants of health such as lifestyle and healthy child and youth development.

Criminal Code Offenses

Impaired Driving Charges

Indicators –  Health System Performance

Outcomes of programs and services of a health system that provide relative measures of performance. In a population of a given health state or geography, what are the facilities and services available that provide health care and are they helping the people who use it? Health infrastructure measures are also included in this part. This part incorporates methodologies from AIM quality dimensions (CCHSE) and the Manitoba Health Performance Measured Framework.

Responsiveness - Availability

The extent to which service(s) and resources (e.g. financial, human, information, equipment) are available to meet the needs of the client and/or community population(s).

Hospital Beds per 1000 Residents in the Area

Full-time Equivalent Physicians per 1000 Residents

Home Care New Cases

PCH Beds per 1000 Population Age 75 and Over

Availability of Fire, Rescue, Paramedic Services

Responsiveness - Accessibility

The ease with which the client and/or community obtains required or available services in the most appropriate setting (Source: Adapted from CCHSA).

e.g. influenza immunization rates, waiting time for surgical and diagnostic procedures, eligibility policy for home care, operating room criteria for slating surgical cases.

Admission to PCH per 1000 in the Last Year

Contact with Medical Doctors

Residents of PCH per 1000 Population

GP and Specialist Visits by Location per 1000 Residents

All Patients: Location of Residence (Pending)

Hospital – Inflow-Outflow

Responsiveness - Timelines

The extent to which services are provided and/or activities are conducted to meet client and/or community needs at the most beneficial or appropriate time (Source: Adapted from CCHSA).

e.g. waitlists for services by department, EMS response times, median waiting time for elective surgery, prioritization criteria for waiting lists.

Median Length of Waiting Times Before Admission

Responsiveness - Continuity

The extent to which coordinated services are provided across the continuum, over time (Source: Adapted from CCHSA).

e.g. patients cared for by multiple departments, percent of departments regionalized/integrated.

Continuity

Responsiveness - Equity

The extent to which decisions are made and services are delivered in a fair and just way (Source: Adapted from CCHSA).

e.g. Yearly visit rate to specialist physicians by community area/region.

Equity

System Competency - Appropriateness

The extent to which services meet the needs of the client and/or community population(s), reflecting best practices (Source: Adapted from CCHSA).

e.g. alternate level of care days, hysterectomy rates, clinical practice guidelines for surgical procedures.

Caesarian Section

Hysterectomy

Tonsillectomy/Adenoidectomy

Vaginal Birth After Caesarian Section

System Competency - Competence

The extent to which individuals’ knowledge, skills, and attitudes are appropriate to the service provided (Source: Adapted from CCHSA).

Approved & Pending Care Maps for Core Services

System Competency - Effectiveness

The extent to which services, interventions, or actions achieve optimal results (Source: Adapted from CCHSA).

e.g. Immunization rates, screening rates, re-admissions within 7 days of discharge.

Ambulatory Care Sensitive Conditions

System Competency - Safety

The extent to which potential risks and/or unintended results are avoided or minimized (Source: Adapted from CCHSA).

e.g. patient injuries by department/cause, complaints, medical errors or adverse drug reactions, use of physical and chemical restraints for inpatient clients.

Safety

System Competency - Legitimacy

The extent to which services and/or activities conform to ethical principles, values, conventions, laws, and regulations (Source: Adapted from CCHSA).

e.g. issues reviewed by the ethics committee.

Legitimacy

System Competency - Efficiency

The extent to which resources (inputs) are brought together to achieve optimal results (outputs) with minimal waste, re-work, and effort (Source: Adapted from CCHSA).

e.g. length of stay, surgical day case rates, alternate level of care days, cost per case mix, day surgeries as a percent of total surgeries, use of caremaps.

Efficiency

System Competency - System Alignment

The extent to which the mission, vision, goals & objectives are clear, well integrated, coordinated and understood both internally and externally. These are reflected in organization plans, delegations of authority, and decision-making processes (Source: Adapted from CCHSA).

e.g. Consistency of board end statements with community health needs.

System Alignment

Client / Community Focus - Communication

The extent to which relevant information is exchanged with the client, family and/or community in a manner that is ongoing, consistent, understandable and useful (Source: Adapted from CCHSA).

e.g. client involvement in care plan, consumer complaints relating to communication, consent for treatment.

Annual General Meeting (AGM)

Complaint Management Process

Easily Accessible Information on Services by Region and Community

External Communication

Current Inventory of Specific Health Programs in Place

Client / Community Focus - Confidentiality

The extent to which information to be kept confidential is safeguarded (Source: Adapted from CCHSA).

e.g. processes in place to protect client confidentiality, complaints relating to confidentiality, PHIA legislation.

Management of Complaints

Management of Confidentiality

PHIA Training

Client / Community Focus - Participation & Partnership

The extent to which the client and/or community actively participates as a partner in decision-making, and in service planning, delivery, and evaluation (Source: Adapted from CCHSA).

e.g. type of community partners/interagency committees, involvement of public in health planning, clients satisfaction with participation levels, community representation.

Advisory Committees (Community Health Advisory Councils)

Community Consultation

Client / Community Focus - Respect & Caring

The extent to which politeness, consideration, sensitivity and respect are incorporated into interactions with the client and/or community (Source: Adapted from CCHSA).

e.g. client satisfaction, client letters of appreciation, patient rights.

Client and Public Input

Evidence of Translation Services

Spiritual Care

Palliative Care Services

Client / Community Focus - Involvement in the Community

The extent to which the organization supports and strengthens the community and its development, and contributes to its overall health (Source: Adapted from CCHSA).

e.g. RHA involvement in community events.

Health / Environmental Issues Partnership

Staff Participation in Community Events

Staff Participation in External Committees

Client / Community Focus - Acceptability

The extent to which care/services provided meet the expectations of the client, community, providers and funding bodies (Source: Adapted from CCHSA).

e.g. client satisfaction level, public satisfaction level

Responses to Results of Client Satisfaction Surveys

Work Life - Open Communication

The extent to which the organization fosters a climate of openness, free expression of ideas, and information sharing (Source: Adapted from CCHSA).

e.g. staff satisfaction scores on worklife, internal communication mechanisms, frequency of staff meetings, staff grievances, arbitration proceedings, collective.

Exit Interviews

Internal Newsletters

Staff Satisfaction Survey

Work Life - Role Clarity

The extent to which staff have clearly defined job scope and objectives, and these are aligned with team and organization goals (Source: Adapted from CCHSA).

e.g. staff have up to-date job descriptions, performance appraisals completed on schedule, new employees receiving orientation.

Staff Orientation

Performance Management Process

Job Descriptions

Work Life - Participation in Decision Making

The extent to which staff input is encouraged and used in decision-making (Source: Adapted from CCHSA).

e.g. opportunities for staff input in decision-making, recommendations made by staff & instituted, staff representation on CQI planning teams/hospital board.

Staff Participation on Internal Committees

Staff / Management Committees

Teamwork Process

Management / Staff Information Exchange

Work Life - Learning Environment

The extent to which staff creativity, innovation, and initiative is encouraged. The necessary training and development, to attain organizational goals and personal/professional development objectives, is provided (Source: Adapted from CCHSA).

e.g. budget allocated to education activities, staff participation/type of staff development initiatives, staff receiving CQI training.

Information Resources

Staff Education Budget

Staff Education Activities

Work Life - Well Being

The extent to which the organization provides a safe, healthy, and supportive environment, recognizes staff contribution, and links staff feedback to improvement opportunities (Source: Adapted from CCHSA).

e.g. occupational health injuries, work days lost due to sickness or injuries, staff recognition activities, average length of service, turnover rate.

Family Friendly Workplace

Staff Diversity

Staff Turnover Rates

Subsidized Health Related Programs

Workplace Wellness Initiatives

Health System Infrastructure - Finances

The operating and capital funds available to the organization and its program/units including recent increases/decreases in funding, flexibility to change priorities, access to additional resources if needed and demands on the organization to respond to changing standards and needs.

e.g. percent of mental health budget allocated to child/adolescent services, percent budget allocated to training and development.

Ratio Between Acute and Community Costs

Administrative Costs as Percentage of Total Operating Costs

Health System Infrastructure - Human Resources

Health workforce structure and distribution.

e.g. number of staff, their level of qualification and training, number of specialists/capita, vacancy rates per staff category, essential services.

Staff Education Needs Assessment

Volunteer Contribution

Position Vacancy Rate: Selected Positions

Length of Time Positions are Vacant

Health System Infrastructure - Leadership

The formal structure/ processes of the organization.

e.g. The degree of development of leadership and team building, reporting mechanisms, strategic planning activities, program evaluation, internal and external collaboration and partnerships and communication, management:staff ratio.

New Programs/Services with Impact Analysis and Evaluation Strategy

Staff/Management Ratio

Management and Leadership Training

Career Advancement

Organizational Chart for External Use

Successor Planning, Including Gender Analysis

Health System Infrastructure - eHealth

Information & Technology – Human knowledge, available technology, degree of integration of internal and external information systems.

e.g. new business intelligence initiatives, IT vacancy rate, number of programs without IT support.

eHealth Strategic Plan

Percent Budget Spent on eHealth Support

Allocated eHealth Funding Relative to Strategic Plan

Information Technology Development

Health System Infrastructure - Physical Structure & Equipment

Physical structures and equipment.

e.g. size and condition of buildings and equipment and their suitability to the population(s) served, the degree of accessibility to those with disabilities and special needs and the degree of difficulty in upgrading or modifying existing property.

Physical Structure – Existing Hospitals

Physical Structure – New Construction

Equipment – Specialized

Health System Infrastructure - Public Health Surveillance

The tracking and forecasting of any health event or health determinant through the collection, integration and analysis of data and the dissemination of information to those who need to know.

e.g. epidemiological research, monitoring, population-based screening, case finding, health surveys.

Immunization for Pneumococcal Disease for Population Aged 65+ (Pending)

Mammography Screening

Cervical Cancer Screening

Influenza Immunization for Seniors

Childhood Immunization: Immunization Coverage for 1, 2, and 7 year olds

Health System Infrastructure - Research

Research funding and structures.

e.g. proportion of the provincial health budget allocated to medical research, research dollars in high priority areas.

Research Projects

Indicators –  Community & Health System Characteristics

Integrates the concepts of population health status and health system performance. Viewing how a given population utilizes health services provides insight into current and future demands on the health system by a population. Utilization and per capita resources compared across jurisdictions, geographies and population sectors, provide a relative measure of system load.

Population Projections

Projected counts for general and special populations.

WHR Population Projections (Under revision)

Aboriginal Population Projections

Expenditures

Dollars spent on health care.

e.g. Percent of administrative cost of total operating costs, PCH resident direct costs of total resident days, total food services costs of total meal days, acute total drug costs excluding anti-neoplastics of total inpatient days.

Health Care Expenditures Per Capita

Distribution of Health Care Expenditures

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