Perspectives is the quarterly newsletter of the New Brunswick Health Council

In this issue...

Stéphane Robichaud
CEO of the NBHC

Message from the CEO

The work of the New Brunswick Health Council is contributing to improving the collective understanding of our province’s population health picture and the quality of its health services. It is also gradually contributing to a common appreciation of our health system’s sustainability challenge. Health system performance reporting is impossible in the absence of health system performance management. To start with, each health system organization, whether it is the Department of Health, Vitalité Health Network, Horizon Health Network and Ambulance New Brunswick, acknowledges that the NBHC’s reports are valuable and can help improve the use of common indicators at the system level and in their respective organizations.

Some of the tools developed by the NBHC have received particular attention from those with either management or public policy responsibilities. For example, the acute care experience survey, which will be undertaken for its third time in the winter of 2015-2016, is now used by both regional health authorities as a reference tool to identify priority improvement areas and to monitor progress over time. The most successful tool produced by the NBHC to date is the series of “My Community at a Glance” community profiles which provide over 300 indicators comparing all communities in the province to provincial averages and to similar-sized communities. Since the spring of 2014, the NBHC has distributed over 2,400 copies to community leaders wishing to use this tool. The community profiles have proven that the more local the information is, the more impact it can have on behaviours.

When the NBHC first started its public reporting work on population health, health service quality and the sustainability of the provincial health system, the absence of provincially standardized information in any of these areas led to an important first lesson.  It proved that the provincial health system had evolved as a sum of multiple isolated decisions. There has never been an integrated provincial plan or strategy based on the health picture of the population or a clear collective understanding of health service quality. The quicker this is collectively acknowledged, the quicker we can learn how to work as a system. After all, it is what citizens expect and it is a reasonable expectation.

The NBHC is not excluded from the need to work differently at the provincial level.  Fortunately, engaging stakeholders in the development of the various measuring and reporting tools has always been a working principle for the NBHC. This has led to constructive working relations that will prove very useful in efforts to improving the use of performance indicators at the system level and by all health system organizations. We now have a better appreciation of wide variabilities in health service quality in the province, rather than simply being aware of where the province is not performing well on average. These variabilities also show that we have geographical areas that perform very well and we must turn our attention to learning from these areas in order to apply lessons learned to areas of low performance.

When we consider the size of the province, the small number of provincial health organizations and the progress in understanding the state of population health and health service quality, New Brunswick is well positioned to be a leader on the national and international stage. 

Upcoming report on health service quality 

As part of its ongoing commitment to providing citizens with important information about the quality of health services delivered in the province, the NBHC will soon be publishing information on the variability in health service quality in New Brunswick.  This follows the release of a Health System Report Card in April and the release of a brief on health system sustainability in July.

Specifically, the report will address the variability in health service quality within the province and the need for an effective provincial accountability framework to improve performance.  This brief, combined with the one released earlier this summer, will show potential areas of focus from the system’s point of view but also from the citizens’ point of view.

This report, in addition to putting forth that the health system should prioritize the primary health sector as well as mental health and addiction services, will also explain that the system must focus its efforts on two of the six dimensions of quality, namely accessibility and appropriateness, since the improvement of these two will have a ripple effect on the other dimensions of quality.  
The NBHC's six dimensions of quality

In order to report publicly on health service quality, the NBHC must consider the following quality dimensions:
  • Accessibility: The ability of patients/clients to obtain care/service at the right place and the right time, based on respective needs, in the official language of their choice
  • Appropriateness: Care/service provided is relevant to the patients’/clients’ needs and based on established standards
  • Effectiveness: Care/service, intervention or action achieves the desired results
  • Efficiency: Achieving the desired results with the most cost-effective use of resources
  • Equity: The ability to provide quality care/service to all, regardless of individual characteristics and circumstances
  • Safety: Potential risks of an intervention or the environment are avoided or minimized

New information about youth available

In September, fact sheets presenting data from the New Brunswick Student Wellness Survey - Kindergarten to Grade 5 for 2013-2014 were added to the NBHC website. These fact sheets present survey results examining the health and wellness attitudes and behaviours of students in kindergarten to grade 5 on the topics of:
  • Healthy Weights and Lifestyle
  • Mental Fitness
  • Social Relationships and Environments
This survey is an initiative of the Department of Social Development in cooperation with the Department of Education and Early Childhood Development. The NBHC did the data collection and analysis. It will be repeated during this school year for grades 6 to 12.
Did you know?

The quality of health services varies greatly throughout New Brunswick in all health sectors, quality dimensions, programs and services. What we observe from analyzing this variability is that while we have poor performers in the province, we also have very good performers.

The system must identify and learn from the better performers' practices to improve health service quality everywhere.

Update on our surveys

The New Brunswick Health Council is partnering with the Horizon Health Network and the Vitalité Health Network to conduct a hospital patient care experience survey. Between the months of December and March, all eligible medical and surgical patients discharged from an acute care hospital will be invited to participate and will receive the paper mail-out survey at home after being discharged.

Participation is voluntary, but very important; it’s the opportunity for citizens to share their views on their recent hospital stay.  The survey will ask questions about the care that was received from the nurses and doctors while in hospital, about the patient personally and about their experiences while in hospital.

The results will help improve patient care in New Brunswick hospitals by identifying what is being done well and what could be better. The responses from the survey will be analyzed to learn more about the experiences of hospital patients and will be compared to the responses from the two previous surveys (2010 and 2013). 

While this survey is running its course, the NBHC is also preparing the release of its home care survey at the beginning of 2016. 
Did you know?

Research shows that making health services accessible and appropriate will also lead to health services that are effective, efficient, and safe. Focusing on improving accessibility and appropriateness can therefore help support health service transformation in New Brunswick.

Would you like to be a member of the NBHC?

The NBHC is composed of 12 members; you can voice your interest in becoming a member by submitting an application before November 20.  

Click here:

The New Brunswick Health Council is a Crown agency established under the New Brunswick Health Council Act to:
  • promote the improvement of health service quality in the Province;
  • develop and implement mechanisms to engage the citizens of New Brunswick in meaningful dialogue for the purpose of improving health service quality in the Province;
  • measure, monitor and assess population health and health service quality in the Province;
  • identify effective practices for the improvement of health service quality in the Province;
  • evaluate strategies designed to improve health service quality in the Province;
  • assess citizen satisfaction with health services and health service quality in the Province;
  • investigate matters respecting the health care system that are referred to it by the Minister;
  • provide recommendations to the Minister with respect to any of the activities described above;
  • take into account the particular needs of the two official linguistic communities in the exercise of the activities referred to above; and
  • to carry out such other activities or duties as may be authorized or required by this Act or as the Lieutenant-Governor in Council may direct.
The NBHC has been established as an independent organization that measures, monitors and evaluates New Brunswick’s health care system performance and population health, and that engages citizens in the improvement of health service quality.
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