HEALTH QUALITY ONTARIO
Contents
1. AN HOO INITIATIVE ResidentsFirst Advancing Quality in Ontario Long Term Care Homes HEALTH QUALITY ONTARIO Quality Improvement Reporting amp Analysis Platform Residents First User Guide Prepared R LC O nta f Version 2 1 Health Quality Ontar Contents 1 Introduction to QIRAP EE EEN 3 2 Uoer ee 3 Me lee ue 3 3 QIRAP Interface at a Glance ec cccccccceeeecceceeeceeceeeeeeeeeeseceessaeeeeesseaeeeesseaeceesseeeeeesaaaeess 3 Set HEGEL IN AWG WON MENU E 3 3 1 1 VE 4 SSC Ee lt 5 G EE 4 3 2 1 ACION BUTON rereana E E E E E 4 See AC INAVON WT peeraa asses y temen doin ted niuerisiranansaienasaeioaceneeirenanaely 4 e DALEN es gucermcetn ceca traceroute E GaetcrntnctaactoacsuoattugonamOastnoaatds 5 71 aer NR ER RONG e eee E E E IE 5 AL NEWN e lee 5 4 2 1 Add Dala POIN Coenen eee ee E E eee 6 4 2 2 Manage Division Home Area 7 4 2 2 1 PROG EDI VISIO e ooueaneeacauacsesentseneeatseeateniaanecandes 8 4 2 2 2 Sale e E 9 4 2 2 3 Delete DEE 9 A23 TUS EE 10 4 2 4 TOW EE 11 4 2 4 1 Add Data Point for Measure 12 4 2 4 2 Edit Data Point for M SULe ccccccceccseeeceeeeeeeeeeeeeeeeeeeeeeeeueeeeeeaeeseeeneenes 13 4 2 5 Manage Favourites E 15 I VOW RODO a E E E fal vee reve cece 16 Bel Eilen ee Sietsntoanechancinnairandiinecieanbnanuia aera iunnanbiaasie aatereactnensinnciomminmctuqnsiachanminaehainamannies 16 5 1 1 NT TN E 16 e FAME FRO DOME TT 19 So EKORO O E 19 o EO OARA e A nen eee er eee 19 Common Ac2. Ta Fails i F a 5 es foe i ne CEE Eo eee ESCHER woo soo 300 sm 00 coo eon Figure 27 View Report Parameters The Run Chart displays according to the selected parameters along with the data table Note Reports with a large dataset may have multiple pages The pagination bar can be used to navigate through the report 17 Group froimert Gow Group sl Merit Fala x Siow Anaoa Ne kd Page Wb e E el z rd re Figure 28 View Report Pagination Run Chart Features Run Charts can display the following features e Median a horizontal line across the graph which represents the median value of the baseline data e Target a horizontal line across the graph indicating the target of the QI team e Annotations comments associated with the data points to provide details such as when improvement ideas were tested e Direction of Improvement An arrow indicating the direction of improved quality is displayed underneath the chart e Baseline Baseline end date is represented by a vertical line on the Run Chart and the baseline date is stated underneath the chart Significant improvement in the QI data can be detected through two 2 tests on a Run Chart e Six 6 or more consecutive points above or below the median e Six 6 consecutive points moving upward or downward The following markers are used on the Run Charts e MM An annotation exists for the data point which is displayed when yo
3. Within the Add Data Point pop up click Manage Division link under the Division drop down menu CoA 1 Outcome Measure New Description Average number of primary PSWs per resident who provide care over a one month period Instructions to data entry user Definition of primary PSW The PSW who is primarily responsible for the ADL s of dressing eating toilet use and personal hygiene Collection plan Monthly Start date a End Date Division Entire Home Manage Division Annotations Fields Figure 9 Data Entry Manage Division 2 The Manage Division section will expand to display all created Divisions Home Areas Manage Division Division Details lq lt q Page i oti p gt KM w View 1 1 of 1 Figure 10 Data Entry Manage Division 4 2 2 1 Add Division To Add Division 1 Click the Add icon within the Manage Division section to add a new Division Home Area Manage Division Division Details Lett Wing Right Wing a Page of 1 View 1 3 of Figure 11 Data Entry Manage Division Add Division 2 Click on the highlighted field to enter the Name of the Division Home Area 1 and the highlighted Division Details 2 to add any details pertaining to the Home Area Manage Division Division Details Left Wing Right Wing i Figure 12 Data Entry Manage Division Add Name and Division Details 3 Click the Save icon on the Manage Div
4. Measures Associated with Selected Topics 1 Click on the Arrow icon next to a Topic to view the measures associated with that Topic Data Entry eee wg mea DP Topics Name 1 o Consistency of PSW Assignment Continence Figure 6 Data Entry View Topics 2 Each measure will have three 3 action buttons next to it Add Measure View Chart View All Data Entry mi a mm a e gt Topics Consistency of PSW Assignment CoA 1 Guicome Average number of primary PSWs per resident who provide care over a one month pernod ei Iz ES FA CO CoA J Process Percentage of staff tumover each month K Los CoA 3 Process Percentage of agency PSW hours each month Ki Lo CoA 4 Balancing Percentage of total PSW paid hours that are paid sick hours each month Ki Los Continence o ED Utilization Figure 7 Data Entry View Topic Expanded Measure View 4 2 1 Add Data Point Users can enter data for quality improvement measures To Add Data for Selected Measure 1 Inthe expanded measures view click on the Add icon next to a measure to add a data point for the measure Data Entry Dm ggf me mmm e gt Topics Consistency of PSW Assignment CoA 1 Qutcome Average number of primary PSVV s per resident who provide care over a one month penod gt CA CoA 2 Process Percentage of staf tumover each month CoA 3 Process Percentage of agency PSW hours ea
5. primary PSWs per resident who provide care over a one month period Instructions to data entry user Definition of primary PSW The PSW who is primarily responsible for the ADL s of dressing eating toilet use and personal hygiene Collection plan Monthly Start date Feb 2013 End Date Feb 2013 Division Entire Home Le Manage Division Annotations Fields of PSWs who were primary caregivers 102 Total number of residents in LTC home 23 Formulas Average Number of PSWs Per Resident 4 43 Figure 21 Data Entry View All Edit Data Point 4 Click Save To Access Run Charts from View All 1 Click on the Chart icon on the View All page to view a Run Chart Report The system loads the Run Chart Report 2 Select parameters 3 A pop up window containing a Run Chart for the selected measure is displayed along with a data table below Note Run Chart and data table will be blank for measures with no data points For more information on the Run Chart Reports see section 5 1 14 4 2 5 Manage Favourites Users can manage favourite topics allowing easy access to selected topics for selected LTC Homes To Manage Favourites 1 Click Data Entry from the navigation menu on the left panel 2 Click the Manage Favourite link Data Entry Select Institution Select an institution Go Figure 22 Data Entry Manage Favourites 3 Check selected topics for LTC Home to be displayed for data entry 4 Uncheck topics
6. ario ca Report ViewReport Figure 26 View Report Pop up Blocker 5 Reports can be viewed for all measures with associated data points The following Report Parameters are used to create a report 16 Report Parameters e Group LTC Home Users can select a LTC Home enrolled in Residents First that they are associated with from the Group drop down menu e Division Users have the ability to select a Division Home Area within the LTC Home or to view an aggregate Note Aggregate chart will not display median target or annotations e Measure Users have the ability to select a measure to view on the Run Chart e Field Users can select a field or formula from the selected measure to view on the Run Chart e Show annotations Users have the ability to display or hide annotations entered from data entry 6 Select Report Parameters 7 Click View Report button Group EI Enroimerd Greup Group D Gomess Entre Hara Measure Fat l a red Tote Fis Formula Show Arewtg serg lis In An ip Fl gt Pape Width sl Fed leg kg op S Fals 1 Humber of bkamful falls that take place each mamih that are categorttet as a7 J 4 5 of 6 on the severity of bam ecole 5 e wm vm F ze mm em vm ze Dignan Er K n e K sage Taik Fis M miim Tig i a m Ki sp Mi a BB RR el a i A8 R S a Re Ba Be ee s e R S F KG Be a ET T E fi i R E Direction of Improvement Baseline End Date aN
7. asure Users can edit data points for measures for a selected LTC Home from the View All grid by clicking on the Edit icon To Edit Entered Data Point from View All Grid 1 Select a data point by clicking on it 2 Click the Edit icon to edit selected data point Data Entry e gl o gt Topics Name Consistency of PSW Assignment Go back to Topics Measure Name CoA 1 Divisions All E Collection Period Division of PSWs primary Total of residents Avg PSWs resident 01 01 2013 Entire Home 19 102 0 19 12 01 2012 Entire Home 16 105 0 17 11 01 2012 Entire Home 15 100 0 15 10 01 2012 Entire Home 20 105 0 19 09 01 2012 Entire Home 21 100 0 21 08 01 2012 Entire Home 20 100 0 20 7 E ld lt 4 Page of 1 p gt pl vis View 1 7 of 7 Figure 20 Data Entry Edit Data Point 3 The data entry pop up window will be displayed and any fields within the pop up can be edited a Edit Start Date by clicking on the Calendar Control 2 Date b Edit Division Home Area from the drop down menu Note The user can manage Division Home Area by clicking on Manage Division See 4 2 4 Manage Division to add edit or delete division c Edit Annotations Edit Field Values for a measure e If user would like to add more data in the next step click Save amp New to add a new data point Otherwise proceed to step 4 Icon beside Start Gs 13 CoA 1 Outcome Measure Edit Description Average number of
8. bsite To Exit QIRAP 1 Click Close Window button Welcome John Smith Close Window Figure 31 Exiting QIRAP 19
9. ch month fo oe o lor gt gt 2 iii iii iii i CoA 4 Balancing Percentage of total PSW paid hours that are paid sick hours each month Continence ED Utilization Falls Prevention Pressure Ulcers Responsive Behaviours Figure 8 Data Entry Add Data Point 2 The data entry screen will pop up for the selected measure Click on the Calendar Control Icon beside Start Date 4 Select a Start Date for the data point Note An End Date will be auto populated by the system 5 Select the Division Home Area from the Division drop down menu The default Home Area is set to the Entire Home To add data for a sub section of the Home users can manage the division by clicking on Manage Division See 4 2 2 Manage Division Home Areal Note The user can manage the division by clicking on Manage Division See 4 2 4 Manage Division to add edit or delete a division Enter Annotations if any 7 Enter Field Values for the measure Note Asterisks indicate mandatory fields 8 Once the mandatory fields are filled out any calculated values for the measure value will appear under Formulas 9 If you would like to add more data in the next step click Save amp New and repeat steps 3 to 7 Otherwise proceed to step 10 10 Click Save ad p 4 2 2 Manage Division Home Area Users can add edit or delete Divisions Home Areas by clicking Manage Division in the Data Entry page To Access Manage Division 1
10. con to view Run Chart The system loads the Run Chart report Data Entry nen me T e gt Topics Consistency of PSW Assignment CoA 1 Quicome Average number of primary PSWs per resident who provide care over a one month penod E Q CoA 2 Process Percentage of staff tumover each month K Lee CoA 3 Process Percentage of agency PSW hours each month Ki E Figure 16 Data Entry Chart 3 A pop up window containing a Run Chart for the selected measure is displayed along with a data table below Note The Run Chart and data table will be blank for measures with no data points For more information on the Run Chart Reports see section 4 2 5 Manage Favourites 4 2 4 View All Users can view all the data points that have been entered for a measure through the View All page Data points can be added edited and or viewed for the selected measure through the grid Run Charts can also be viewed from here To View All Entered Data Point s for a Selected Measure 1 Click on the Topic name to see the associated measures 2 Click on the View All icon Data Entry m ggf ww eel e s Bb lt gt Topics Consistency of PSW Assignment CoA 1 Qutcome Average number of primary PSWs per resident who provide care over a one month pernod To Je e BE iii dml Q CoA 2 Process Percentage of staf tumover each month Figure 17 Data Entry View All 11 3 The View All page will display all
11. data points entered for the measure 1 Users also have access to several action buttons 2 within this page including Add Data Point Edit Data Point and View Chart Data Entry a am ms _ S gt Topics Name Consistency of PSW Assignment Go back to Topics Measure Name CoA 1 Collection Period 01 01 2013 1401 2012 11 01 2012 1001 2012 0801 2012 0801 2012 Division Entire Home Entire Home Entire Home Entire Home Entire Home Entire Home Divisions All of PSWs primary Total of residents Avg PSWsiresident gt Filter View 1 7 of f ld o Page 1 of1 p gt pl OL Ez Figure 18 Data Entry View All Chart 4 2 4 1 Add Data Point for Measure Users can enter data for measures for a selected LTC Home from the View All grid by clicking on the Add F icon See 4 2 1 Add Data Point Data Entry n wf H gt Topics Name Consistency of PSW Assignment w Go back to Topics Measure Name CoA 1 Divisions Ajj Avg PSWs resident Collection Period Division of PSWs primary Total of residents 01 01 2013 Entire Home 19 102 0 19 12 01 2012 Entire Home 18 105 0 17 11 01 2012 Entire Home 15 100 0 15 10 01 2012 Entire Home 20 105 0 19 09 01 2012 Entire Home 21 100 0 21 08 01 2012 Entire Home 20 100 0 20 Z ks d i Page 1 off gt P ts View 1 7 of 7 Figure 19 Data Entry Add Data Point 12 4 2 4 2 Edit Data Point for Me
12. erent menu items 3 1 1 Measures Data Entry The Data Entry interface is used by users to view or enter data points for measures View Report The View Report interface is used by users to view Run Charts for measures MEASURES DATA ENTRY VIEW REPORT Figure 3 Left Navigation Menu Measures 3 2 Table Grids Table grids exist throughout the application allowing users to easily view data and perform tasks Field H Label to apppear on screen Vers 1 10 of 11 Figure 4 Table Grids 3 2 1 Action Buttons Action buttons are located in almost all of the grids within QIRAP These buttons are features for users to perform various functions within the interface 3 2 2 Pagination Bar Pagination bar exists in all the grids Select the left or right arrow to navigate pages or select a value in the drop down to display more fields within the grid at a time 4 Data Entry 4 1Select LTC Home To View Topics and Associated Measures for a Selected LTC Home 1 Click Data Entry from the navigation menu on the left panel 2 Select the LTC Home from the drop down menu 3 Click Go MEASURES Data Entry DATA ENTRY 1 VIEW REPORT E 2 Select a LTC Home Le 3 Manage Favorite Figure 5 Data Entry The application will proceed to the Topics page which displays each Topic within Residents First 4 2 View Topics Each Topic within Residents First will be displayed on the Topics page To View
13. ision grid Note To cancel changes click the X icon 4 2 2 2 Edit Division To Edit Division 1 Within the Manage Division section select a Division Home Area 2 Click the Edit icon to edit the selected division Manage Division Division Details Right Wing oie T Bo ld Paon on ais View 1 2 of 2 Figure 13 Data Entry Manage Division Edit Division 3 Edit Division Name 1 and Division Details 2 by clicking on the highlighted area Click the Save icon on the Manage Division grid Note To cancel changes click the X icon 4 2 2 3 Delete Division Note If there are data points entered for a Division Home Area the Division Home Area cannot be deleted To Delete a Division Home Area 1 Within the Manage Division section select a Division Home Area by clicking on it 2 Click the Delete il icon E Manage Division Name Division Details Right Wing afn amp La lt q Page 1 of p gt p pls View 1 2 of 2 Figure 14 Data Entry Manage Division Delete Division 3 Click Yes to confirm delete SR Are you sure you want to delete select division St Figure 15 Data Entry Manage Division Delete Division 4 2 3 Run Charts Run Charts for measures can be viewed through either the Data Entry View Topics page or through View Reports See section 5 1 To Access Run Charts 1 Click on the Topic name to see associated measures 10 2 Click on the Chart i
14. ronyms used in QIRAP User Manual HQO Health Quality Ontario QIRAP Quality Improvement Reporting amp Analysis Platform LTC Long Term Care Figure 1 Common Acronyms 1 Introduction to QIRAP The Quality Improvement Reporting and Analysis Platform QIRAP provides a single integrated platform for reporting and analysis of quality improvement QI measures for Residents First Advanced Access Efficiency amp Chronic Disease Management and bestPATH initiatives End users such as long term care homes primary care practices hospitals and QI Coaches can enter data for measures through intuitive web pages as well as use the reporting capability of the platform to view Run Charts for each measure Administrators of the system are HQO representatives who have the ability to perform tasks such as manage users and their roles manage measures and run numerous analysis reports 2 User Access 2 1 Functionalities The following table outlines the permissions that the data entry user and view only user has in the application User Access Functionality Data Entry View Only Add data cx Edit data xf x Figure 2 User roles 3 QIRAP Interface at a Glance 3 1 Left Navigation Menu The QIRAP user interface displays a fixed left navigation panel on the left hand side of the page for easy access on each page of the application Please Note depending on users role and privileges the left navigation menu may display diff
15. to be hidden for data entry Data Entry Select LTC Home Select a LTC Home Go Manage Favorite Description Continence Continence ED Utilization Emergency Department Utilization ei Page 1 of d ls View 1 6 of 6 Figure 23 Data Entry Manage Favourites 5 Click the Save I icon on the Manage Favourite grid 15 5 View Report 5 1 Viewing Reports Users can access Run Charts for their associated LTC Home s A Run Chart is a graph that illustrates changes in quality over time Measurements are taken at frequent points in time and connected with a line This provides a graphical display of variation over time and can help a QI team see if their changes have led to improvement 5 1 1 View Run Chart To View a Run Chart 1 Click View Report from the navigation menu on the left panel MEASURES View Report DATA ENTRY x Select Report VIEW REPORT Run Charts Bj view Figure 24 View Report 2 Select the report from the drop down menu 3 Click View button MEASURES DATA ENTRY VIEW REPORT Figure 25 View Report 4 A pop up window will display the Reports page Note If you receive a pop up blocker message select Allow pop ups for girap hgontario ca Lei Web browser prevented this site from opening a pop up window Allow pop ups for girap hgontario ca Edit Pop up Blocker Options Don t show this message when pop ups are blocked Show http qirap hqont
16. u scroll over the point on the graph e Six 6 or more consecutive points above or below the median Run Chart rule e T Six 6 or more consecutive points moving upward or downward Run Chart rule e KA Both Run Chart rules are achieved 18 5 1 2 Print Report To Print Report 1 Click on the Print Zi icon underneath the Report Parameters to print the Run Chart and data table Group Enrollment Group Group D S Division Entire Home e Measure Falls 1 sl Field Total Falls Formula EN Show Annotations No EN ia of 1 of 1i p R d i Page Width EN Find Next el GG i Figure 29 View Report Print Report 5 1 3 Export Report To Export Report 1 Click on the Export il icon underneath the Report Parameters to export the Run Chart and data table into a variety of formats Available formats include XML file with report data CSV comma delimited PDF MHTML web archive Excel TIFF file Word Group EN Enrollment Group Group D Division Entire Home EN Measure Falls 1 Field Total Falls Formula EN Show Annotations No e WM A fi b pi D Page Width Find Next hie wm file with report data CSV comma delimited POF MATML web archive Excel TIFF file Word Figure 30 View Report Export Report 6 Exiting QIRAP A Close Window button is located at the top right corner of the page Please Note Closing QIRAP does not log you out of the Health Quality Ontario we
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