Ontario hospitals have made a commitment to transparency and accountability by publicly reporting patient safety quality indicators. On this site, you can explore patient safety indicator results for more than 200 Ontario hospitals.
Health Quality Ontario (HQO) currently reports on nine quality indicators for individual hospitals. These indicators cover hospital-associated infections, hand hygiene compliance among hospital health care workers and the use of the Surgical Safety Checklist.
To find quality indicator results for a particular hospital, use the tabs on the left-hand side of this page to search by hospital name or location. You can also browse results by Local Health Integration Networks (LHINs) and hospital type.
“Not Required to Report” indicates that the hospital is not required to report data for a particular indicator. Data are only reported for eligible hospitals (e.g., hospitals that have an Intensive Care Unit for CLI and VAP, or hospitals that perform knee or hip surgery for SSI).
More about these indicators
What is C. difficile? C. difficile is a bacterium that can either live in the bowel, as part of normal bowel flora, without causing harm, or it can cause an infection (diarrhea, fever, abdominal pain). Infection can occur when a person has been on antibiotics. The antibiotics can upset the normal balance of the bowel, leading to Clostridium difficile Infection. The effects of CDI are usually mild but sometimes can be severe. Symptoms range from mild diarrhea to high fever, abdominal cramping, abdominal pain, and dehydration. In severe cases, surgery may be needed, and in extreme cases CDI may cause death.
What are the risk factors? Certain people are at a higher risk for acquiring CDI. These risk factors include: the history of antibiotic use; bowel surgery; chemotherapy; prolonged hospitalization; being elderly; and a serious underlying illness or debilitation. In the case of C. difficile, it is thought that the overuse or inappropriate use of certain types of antibiotics has played a role in the increasing toxicity of the bacteria.
Why is this important to measure? Measuring, monitoring and reporting Clostridium difficile Infections is one part of a comprehensive Infection Prevention and Control (IPAC) program. The information gathered can assist hospitals with evaluating the effectiveness of their infection prevention and control interventions and make further improvements based on this information.
Ways to help: There are a few simple things you can do to help:
Please visit the Hospital Infections section of the Quality Monitor report for further ideas for improvement.
What is MRSA? Staphylococcus aureus is a type of bacteria that lives on the skin and mucous membranes of healthy people. Occasionally, it can cause an infection. When S. aureus develops resistance to certain antibiotics, it is called Methicillin-Resistant Staphylococcus aureus, or MRSA. MRSA can either live on the skin or mucous membranes (e.g. nose) of a person without causing harm (called colonization), or it can enter the body through artificial openings (e.g. wounds, IV lines) and cause infections like blood stream infections or bacteremia. MRSA infections can be challenging to treat because the bacteria are resistant to some antibiotics.
What are the risk factors? Risk factors for contracting MRSA include invasive procedures, prior treatment with antibiotics, prolonged hospital stay, stay in an intensive care or burn unit, surgical wound infection and close proximity to a person with MRSA. MRSA can also be transmitted from a mother to her child through breast milk.
Why is this important to measure? Measuring, monitoring and reporting MRSA bacteremia is one part of a comprehensive Infection Prevention and Control (IPAC) program. The information gathered can assist hospitals with evaluating the effectiveness of their infection prevention and control interventions and make further improvements based on this information.
Ways to help: There are a few simple things you can do to help:
Please visit the Hospital Infections section of the Quality Monitor report for further ideas for improvement.
What is VRE? Enterococci are bacteria that live in the gastrointestinal tract (bowels) of most individuals and generally do not cause harm. Vancomycin-Resistant Enterococci (VRE) are strains of the enterococci bacteria that are resistant to the antibiotic Vancomycin. VRE can either live in the bowel of a person without causing harm (called colonization), or it can enter the body through artificial openings (e.g. wounds, IV lines) and cause infections like bloodstream infections or bacteremia. VRE infections can be challenging to treat because the bacteria are resistance to some antibiotics.
What are the risk factors? Risk factors for contracting VRE include a serious underlying illness, presence of invasive devices, and prior colonization with VRE, antibiotic use and a prolonged hospital stay.
Why is this important to measure? Measuring, monitoring and reporting VRE bacteremia is one part of a comprehensive Infection Prevention and Control (IPAC) program. The information gathered can assist hospitals with evaluating the effectiveness of their infection prevention and control interventions and make further improvements based on this information.
Ways to help: There are a few simple things you can do to help:
Please visit the Hospital Infections section of the Quality Monitor report for further ideas for improvement.
What is CLI? A central venous catheter (or “line”) is fed through a vein and provides access to major blood vessels (e.g. aorta, pulmonary artery). A typical intravenous line or IV is not considered a central line. These lines are inserted through artificial openings in the skin, which decreases the ability of the body to keep out bacteria. A Central-line primary bloodstream infection (CLI) occurs when bacteria get into the line and spread to the bloodstream causing infection.
What are the risk factors? Anyone who has a central line can get an infection. The risk is higher if you are in the intensive care unit (ICU), have a serious underlying illness or weakness, are receiving bone marrow or chemotherapy, or have the line in for an extended time.
Why is this important to measure? Measuring, monitoring and reporting rates of CLI are one part of a comprehensive Infection Prevention and Control (IPAC) program. The information gathered can assist hospitals with evaluating the effectiveness of their infection prevention and control interventions and make further improvements based on this information.
Ways to help: You can ask lots of questions. Find out why you need a central line and where it will be placed, and learn what steps the hospital is taking to reduce the risk of infection. Try not to touch your central line or dressing.
Wash your hands often for at least 15 seconds using soap and running water or with alcohol-based hand rub, until hands are dry. Special attention should always be paid to cleaning fingertips, between fingers, backs of hands and the thumbs.
Improving hand hygiene is an effective way to reduce the spread of infections.
Please visit the Hospital Infections section of the Quality Monitor report for further ideas for improvement.
What is VAP? Critically ill patients may require the assistance of a ventilator to breathe. When ventilated, microorganisms may get into the patient’s lungs causing pneumonia or ventilator-associated pneumonia (VAP). Since VAP is caused by bacteria in the lungs, it is treated by using antibiotics.
What are the risk factors? Risk factors include being on a ventilator for more than 48 hours, recent hospitalization (last 90 days), residence in a nursing home, prior antibiotic use (last 90 days), and having dialysis treatment in a clinic.
Why is this important to measure? Measuring, monitoring and reporting rates of VAP are one part of a comprehensive Infection Prevention and Control program. The information gathered can assist hospitals with evaluating the effectiveness of their infection prevention and control interventions and make further improvements based on this information.
Ways to help: Families of patients can ask lots of questions; such as what precautions the hospital is taking to prevent VAP.
Hand washing needs to be incorporated into the daily routine. Hospitals usually display hand hygiene practice reminders or memory aids, and make them visible to health care providers, families and visitors. Improving hand hygiene – through frequent hand washing for at least 15 seconds using soap and running water or with alcohol-based hand rub, until hands are dry – is an effective way to reduce the spread of infections.
Please visit the Hospital Infections section of the Quality Monitor report for further ideas for improvement.
What is SSI prevention? Surgical Site Infection can occur when germs enter the patient’s body through the surgical site. Surgical site infections can be superficial infections involving the skin only. Other surgical site infections are more serious and can involve tissues under the skin, including organs. One of the ways to prevent surgical site infections is by giving patients antibiotics 0 to 60 minutes (for usual antibiotics) or 0 to 120 minutes (for an antibiotic known as Vancomycin) before they go into surgery. Most infections are treated with antibiotics. An infected skin wound may be reopened and cleaned.
What are the risk factors? The risk of acquiring a surgical site infection is higher if you are an older adult, have a weakened immune system or other serious health problem, such as diabetes. You are also at higher risk if you smoke, are malnourished (don’t eat enough healthy foods) or are very overweight.
Why is this important to measure? Measuring, monitoring and reporting rates of SSI prevention are one part of a comprehensive Infection Prevention and Control program. The information gathered can assist hospitals with evaluating the effectiveness of their infection prevention and control interventions and make further improvements based on this information.
Ways to help: You can help prevent surgical site infections:
Please visit the Hospital Infections section of the Quality Monitor report for further ideas for improvement.
What is Hand Hygiene Compliance? Hand hygiene is the action of cleaning hands. Hand hygiene compliance occurs when health care workers follow good hand hygiene protocol at the following moments: before initial contact with a patient or patient’s environment, before an aseptic (free of germs) procedure, after body fluid exposure risk and after contact with a patient or patient’s environment. Only data on before initial patient contact and after patient contact are publicly reported on hand hygiene compliance.
Why is this important to measure? Bacteria that can cause infection can move from patient to patient on the hands of healthcare workers. A comprehensive hand hygiene program is part of any effective infection prevention and control (IPAC) program. Measuring and monitoring hand hygiene compliance can assist hospitals with evaluating the effectiveness of their infection prevention and control interventions and make further improvements based on this information.
Ways to help: Improving hand hygiene – through the use of alcohol-based hand rub or soap and running water – is an effective way to reduce the spread of infections.
Hand hygiene needs to be incorporated into the daily routine. Hospitals display hand hygiene practice reminders or memory aids, and make them visible to health care providers, patients and visitors.
Good hand hygiene involves washing hands often for at least 15 seconds using soap and running water or with alcohol hand rub, until hands are dry. Special attention should always be paid to cleaning fingertips, between fingers, backs of hands and the thumbs.
Patients should clean their hands:
Patients and families can take a more active role in promoting good hand hygiene. You can ask or remind health care providers to follow a proper hand hygiene protocol when one of the four moments of hand hygiene has been missed or forgotten.
Please visit the Hospital Infections section of the Quality Monitor report for further ideas for improvement.
What is SSC? The Surgical Safety Checklist is a one-page list that covers about 26 of the most common tasks and items (may vary by hospital) that operating room teams carry out to ensure patient safety. Surgical Safety Checklist compliance measures the percentage of surgeries in which the checklist was used.
Why is this important to measure? The checklist was developed by the Canadian Patient Safety Institute as a tool to support safe patient care through professional preparation, communication and teamwork. The consistent use of this checklist has been shown to reduce the rates of death and complications associated with surgical care.
Ways to help: Patients and family members can discuss the potential for using the Surgical Safety Checklist with the surgeon. Print a copy before the surgery to become more familiar with the checklist and ask any member of the surgical team if will be used in your case. Answer all the questions that staff may ask such as name, date of birth, allergies and other health information, which is intended to prepare you for your surgery and to keep you safe.
Please visit the Adverse Events in Acute Care Hospitals section of the Quality Monitor report for further ideas for improvement.
What is HSMR? The Hospital Standardized Mortality Ratio (HSMR) is a ratio that compares actual number of deaths in hospitals with the expected number of deaths among patients in acute care facilities. Adjustments are made for several factors such as age, sex, diagnosis and admission status that may affect in-hospital mortality rates.
Why is this important to measure? HSMR is an important measurement tool that provides hospitals with a starting point to assess their mortality trends, identify opportunities for improvement and track their progress.
Ways to help: Read the patient education flyers and fact sheets available on the Links and Resources page to become more familiar with hospital-associated infections, surgical site infection prevention, hand hygiene and surgical safety. Discuss potential questions or concerns with your health care provider. Ask lots of questions and learn what steps the hospital is taking to prevent and reduce mortality.
Please visit the Mortality in Hospitals section of the Quality Monitor report for further ideas for improvement.