ACCOUNTABLE CARE
Patient, provider and system outcomes are managed, met and reported on.
- Focus on increasing capacity and improving performance.
- Ensure transparency through user-friendly reporting on service delivery information and outcomes.
- Use performance metrics and outcomes to inform planning and delivery.
- Foster adaptive leadership and governance to facilitate change and collaboration.
Choose the specific policy or program issue, review the possible tools and reports (title, date and precise), select the one that best suits your needs (click learn more for a detailed description) and click on the to access the on-line resource.
If you would like to share a resource for the Knowledge Centre – contact the CHCA Team at: chca@cdnhomecare.ca
Policy Issue: Performance metrics
Program Issue: Quality measures
Performance Indicators
Indicators
Canadian Institute for Health Information, 2013
This document describes what health indicators are and how they can be used to monitor the health of populations and health systems.
Performance Targets
Patients Canada, 2014
This document describes the development of practical measures to identify how well healthcare organizations are doing in delivering patient-centred care.
Learn More
Performance Targets
- Description: The document describes why and how key performance targets are being developed to assess patient and family centred care. The focus is on processes, policies and/or training that can be implemented and measured.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Policy
Performance Reporting
Canadian Institute for Health Information, 2014
This document provides a brief description of an initiative designed to improve pan-Canadian reporting of health indicators that is tailored to fit the information needs of different audiences.
Learn More
Performance Reporting
- Description: This document provides links to several analytical and interactive resources which can be used to improve the care and health of Canadians as well as increase transparency and clarity in the health care system.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Policy and program
Performance Measures
Alberta Health Services, 2014
This article describes new performance measures that can help Albertans understand how the province’s health system is performing.
Learn More
Performance Measures
- Description: This article describes 16 new performance measures which are intended to reflect a better balance across the spectrum of health care and health system performance than previous performance measures. The measures are aligned with Alberta’s Quality Matrix for Health.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Programming and service delivery
The Use of Quality Indicators to Promote Accountability in Health Care: The Good, the Bad, and the Ugly
Forster, A.J., & van Walraven, C., Open Medicine, 6 (2), 2012
This article discusses the use of quality indicators to assess accountability in health care.
Learn More
The Use of Quality Indicators to Promote Accountability in Health Care: The Good, the Bad, and the Ugly
- Description: This document focuses on both positive and negative consequences related to the measurement of three quality indicators commonly used to improve accountability in health care in Canada. The indicators are: hospital standardized mortality ratio; all-cause urgent readmissions; and emergency department length of stay.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Programming and service delivery
Measuring What Matters: The Cost vs. Values of Health Care
Snowdon, A., Schnarr, K., Hussein, A., & Alessi, C. International Centre for Health Innovation, 2012
This document discusses the misalignment between Canadians’ core health values and how Canadian health system performance is measured and funded.
Learn More
Measuring What Matters: The Cost vs. Values of Health Care
- Description: The document addresses: what Canadians value with respect to health care; how Canadians’ values are aligned with health system spending and costs; how Canadians’ values are aligned with measures of health system performance; and how costs and values compare globally.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Policy and program
Home Care Standards for Quality Service. Edition 3.1
Nova Scotia Department of Health and Wellness , Continuing Care Branch, 2011
This document presents home care standards related to governance and accountability, the provision of care to clients, and support services.
Learn More
Home Care Standards for Quality Service. Edition 3.1
- Description: This document identifies Nova Scotia’s home care goals, standards and indicators. It contains a self-assessment tool that organizations can use to rate their compliance to the standards as well as a provincial auditing tool.
- Work originates from: Canada
- Resource can be applied to: Home and community care sector
- Applicable to: Programming and service delivery
Policy Issue: Public reporting
Program Issue: Quality Reporting
Transparency
Health Quality Ontario’s Home Care Indicator Reporting
Health Quality Ontario, 2012
This document describes an initiative designed to measure and publicly report on the quality of home care services and client satisfaction in Ontario.
Learn More
Health Quality Ontario’s Home Care Indicator Reporting
- Description: Health Quality Ontario is mandated by the province of Ontario to publicly report on home care indicators. The indicators are reported for the public, providers and policy-makers. Most of the data are gathered through the RAI-HC assessment tool and are only available for long stay home care clients.
- Work originates from: Canada
- Resource can be applied to: Home and community care sector
- Applicable to: Policy
Guide to Home Care Reporting
Health Quality Ontario, 2015
This article describes data sources for the home care indicators reported by Health Quality Ontario.
Learn More
Guide to Home Care Reporting
- Description: Health Quality Ontario receives indicator results from several sources: including the Canadian Institute for Health Information; the Institute for Clinical Evaluative Sciences; the Ontario Ministry of Health and Long-Term Care; and the Ontario Association of Community Care Access Centres. Data for long-stay home care clients is also collected through the RAI-HC.
- Work originates from: Canada
- Resource can be applied to: Home and community care sector
- Applicable to: Policy
Home Care in Canada: Advancing Quality Improvement and Integrated Care
Accreditation Canada and the Canadian Home Care Association, 2015
This report identifies a number of findings obtained through Accreditation Canada’s Qmentum program and the Canadian Home Care Association.
Learn More
Home Care in Canada: Advancing Quality Improvement and Integrated Care
- Description: The report highlights strengths and opportunities identified through the use of a number of quality improvement tools. It also describes several promising practices identified through the engagement of home care providers and organizations across Canada.
- Work originates from: Canada
- Resource can be applied to: Home and community care sector
- Applicable to: Programming and service delivery
Progress Report 2013: Health Care Renewal in Canada
Health Council of Canada, 2013
This document is the third report produced by the Health Council of Canada regarding progress made on commitments in the 2003 and 2004 national health accords.
Learn More Progress Report 2013: Health Care Renewal in Canada
Policy Issue: Accountable governance models
Program Issue: Defining roles and responsibilities
Shared Accountability
Approaches to Accountability
Healthcare Policy, Vol. 10 (Special Issue), 2014
This special issue highlights a research program at the University of Toronto which focuses on accountability in the Ontario health care system.
Learn More
Approaches to Accountability
- Description: This collection of papers documents how accountability is developed and structured across various components of the health care system in Ontario. The following papers are of particular importance: Thinking About Accountability (R. Deber, p. 12); Home and Community Care Sector Accountability (C. Steele Gray, W. Berta, R. Deber & J. Lum, p. 56); and What Have We Learned from the Substudies? (R. Deber, p. 163).
- Work originates from: Canada
- Resource can be applied to: Home and community care sector
- Applicable to: Policy and program
Principles for Governance, Management, Accountability and Shared Responsibility
CCAF-FCVI Inc. & Canadian Healthcare Association, 2004
This document identifies a set of overarching principles that provide a focus and direction for governing and sharing responsibility within the health system.
Learn More
Principles for Governance, Management, Accountability and Shared Responsibility
- Description: Eleven principles, based on the knowledge, experience and advice of multiple stakeholders, provide a way to achieve a well-managed health system. Five principles provide guidance on governance, management and accountability. The remaining six principles focus on key issues which health systems partners can work on together. Collectively, the principles are intended to promote both coherence and flexibility across jurisdictions.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Policy and program

Fooks, C., & Maslove, L. Canadian Policy Research Networks, 2004
This document explores the concept of accountability and how it appears to be applied in health care.
Learn More
Rhetoric, Fallacy or Dream? Examining the Accountability of Canadian Health Care to Citizens
- Description: This report reviews general concepts of accountability and how they relate, or do not relate, to the delivery of health care in Canada. It also identifies several gaps which need to be addressed by policy makers to improve accountability in health care.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Policy and program

Institute of Public Administration of Canada, MNP LLP, and Fasken Martineau DuMoulin LLP, 2013
This document provides a brief overview of the health care governance system in all ten provinces, the Yukon and the Northwest Territories.
Learn More
Healthcare Governance Models in Canada. A Provincial Perspective
- Description: This document focuses on governance at a systems level. It highlights policies and health care initiatives designed to address a number of key governance issues related to: rising health care costs; patient and family expectations; fiscal constraints; and provincial, regional and local models of care. Information regarding key pieces of legislation is included for each jurisdiction.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Policy and program
Policy Issue: Continuous Quality Improvement
Program Issue: Continuous quality improvement / Patient satisfaction
Continuous Improvement
What is Quality Improvement?
Health Quality Ontario, 2015
This document provides a definition of quality improvement and describes how it can be used.
Learn More
What is Quality Improvement?
- Description: The document identifies nine attributes of a high quality health system. These attributes include being: accessible; effective; safe; patient-centred; equitable; efficient; appropriately resourced; integrated; and focused on population health.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Policy and program
Continuing Care Quality Management Framework
Alberta Health Services, 2014
This document describes the development of a management framework, supported by leadership, which supports continuous quality improvement.
Learn More
Continuing Care Quality Management Framework
- Description: Structure, functions, responsibilities, and accountabilities for monitoring, improvement, and operational delivery of quality care and service that may affect individuals receiving continuing care services. Includes principles relevant to: putting people and their families at the centre of their health care; being committed to quality and safety; fostering a culture of trust and respect; focusing on wellness and public health; enabling decision-making using the best available evidence; and ensuring equitable access to timely and appropriate care.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Policy and program
Exploring the Fit between Organizational Culture and Quality Improvement in a Home-Care Environment
Firbank, O.E., Health Care Management Review, 35 (2), 147-160, 2010
This article discusses how differing organizational cultures appear to affect agency receptivity to continuous quality improvement during program implementation.
Learn More
Exploring the Fit between Organizational Culture and Quality Improvement in a Home-Care Environment
- Description: In this study, data were gathered from public, private, and not-for-profit home care providers. The findings indicated that a core set of attributes affect an agency’s receptivity to continuous quality improvement. These attributes include: a team oriented culture; organizational commitment and involvement of personnel; decentralized decision making; and organizational progressiveness.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Policy and program

Boechler, V., Neufeld, A., McKim, R., The Canadian Journal of Program Evaluation, 17(1), 97-117, 2002
This article discusses the assessment of client satisfaction with a community health centre that is based on primary health care principles.
Learn More
Evaluation of Client Satisfaction in a Community Health Centre: Selection of a Tool
- Description: This article reviews a number of client satisfaction tools and describes the modification of an existing tool to assess client satisfaction with a community health centre. The article also suggests that, in addition to satisfaction surveys, focus groups and individual interviews should be used in evaluating client satisfaction.
- Work originates from: Canada
- Resource can be applied to: Health care sector
- Applicable to: Programming and service delivery

Milne, V., Konkin, J., & Tepper, J., Healthy Debate, 2014
This document presents a debate regarding the provision of adequate home care services in Ontario.
Learn More
How Should We Measure Quality in Home Care?
- Description: This article discusses the delivery of home care in Ontario, the use of patient satisfaction surveys and efforts to track quality of care across Canada.
- Work originates from: Canada
- Resource can be applied to: Home care and community care sector
- Applicable to: Programming and service delivery

McLeod, B., & Sawatzky, R., Hospice Palliative Care and Trinity Western University, 2015
This power point presentation describes a collaborative research initiative which involves both patient-reported outcome measures and patient-reported experience measures.
Learn More
Enhancing the Voices of Palliative Homecare Clients and Their Families
- Description: This presentation describes the implementation and integration of an electronic innovation, the Quality of Life Assessment and Practice Support System (QPSS), into routine palliative home care for older individuals who have an advancing life-limiting condition and their family caregivers.
- Work originates from: Canada
- Resource can be applied to: Home care and community care sector
- Applicable to: Programming and service delivery

Registered Nurses Association of Ontario, 2006
This worksheet enables health care providers, policy makers and others to identify potential ideas for improvement and then test them out.
Learn More
PDSA Cycle Work Sheet
- Description: The worksheet can be used for multiple Plan-Do-Study-Act (PDSA) cycles. It enables individuals or groups to: identify the plan for each cycle; document how the change was implemented; gather data and summarize what was found; and decide whether the change will be maintained and/or whether another PDSA cycle will be implemented.
- Work originates from: Canada
- Resource can be applied to: Multiple sectors
- Applicable to: Policy and program

Australian Government Department of Health and Aging, 2010
This guide is designed to assist service providers in responding to the requirements of the Standards during a quality review of their services and help them continuously improve.
Learn More
Community Care Common Standards Guide
- Description: This resource identifies the three Community Care Common Standards (effective management; appropriate access and service delivery; and service user rights and responsibilities), principles that summarize the intent of each standard, and 18 expected outcomes. It also includes information on quality review tools and processes, performance measures, and related documents.
- Work originates from: Australia
- Resource can be applied to: Home and community care sector
- Applicable to: Programming and service delivery