1. What is C-HOBIC?
C-HOBIC (Canadian Health Outcomes for Better Information and Care) is a project that introduces a systematic, structured language to patient assessment and documentation, in acute care, complex continuing care, long-term care and home care. Sponsored and managed by the Canadian Nurses Association, and funded with contributions from Canada Health Infoway and other provincial partners, C-HOBIC uses the same methodology developed in Ontario through its HOBIC program.
These clinical outcomes have a concept definition, a valid and reliable measure, and empirical evidence linking them to nursing inputs or interventions. Each concept is mapped to ICNP, the clinical reference terminology for nursing developed by the International Council of Nurses, which provides a standardized clinical term and an associated coding.
Phase 1 of C-HOBIC (May 2007 to June 2009) was implemented in Ontario (acute care, long-term care, complex continuing care and home care), Manitoba (long-term and home care) and Saskatchewan (long-term care). In this phase, nurses were taught about collecting standardized clinical outcomes and how to use this information to plan for and evaluate care.
Phase 2 of C-HOBIC (currently underway) is due to be completed in March 2014. In Manitoba, the second phase of C-HOBIC will build standardized measures into admission and discharge assessment screens (with the Allscripts system) at the St. Boniface Hospital. Using C-HOBIC’s clinical information, St. Boniface will make available a synoptic report to support patient transitions from acute care to other health-system sectors. In Ontario, this same type of synoptic report will be available on the ClinicalConnect portal to assist patient transitions within a Local Health Integration Network (LHIN).
2. What are the objectives of C-HOBIC?
C-HOBIC’s aims are to
3. What are the benefits of collecting this information?
There are many benefits to collecting this standardized suite of clinical data:
4. How does C-HOBIC contribute to the priorities for health-care renewal in Canada?
The collection of standardized clinical information across the continuum of care will support patient safety, increase the use of information technology and provide clinical information to support professional accountability.
5. Are there other benefits to collecting the C-HOBIC data set?
The C-HOBIC team has been in discussions with the Canadian Institute for Health Information (CIHI) about ways to include C-HOBIC data in the Discharge Abstract Database (DAD). Including the C-HOBIC data set in DAD will provide standardized patient-centred outcomes data to support aggregation and analysis of clinical outcomes, health-system use and performance reporting.
With C-HOBIC data sets at CIHI, we could also link it with other data sets, such as those in home care and long-term care homes, and understand clinical outcomes across the continuum of care.
6. Is C-HOBIC different from the Canadian National Nursing Quality Report (NNQR-C) or the Nursing Quality Indicators for Reporting and Evaluation (NQuIRE)?
C-HOBIC is working in collaboration with NNQR-C and NQuIRE (a Registered Nurses’ Association of Ontario initiative). Together, these programs are best seen as complementary: C-HOBIC focuses on patient assessment and outcome data; NNQR-C on data to report nursing and organizational performance; and NQuIRE on nursing interventions and best practices.
All three initiatives recognize the use of evidence-based, meaningful quality indicators as an essential component of accountability for a sustainable health-care system.
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