Patient Safety

Patient Safety Indicator results at Health Quality Ontario

Effective December 2012, patient safety indicator results, as reported by Ontario hospitals, as well as other patient safety information, are available on Health Quality Ontario’s (HQO) website. Publically reporting patient safety indicators aligns with HQO’s mandate to monitor and report on Ontario’s health care system to the public.

Public reporting also increases transparency and accountability, and supports quality improvement efforts. View provincial and individual hospital results of nine patient safety indicators on the Health Quality Ontario website.

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Patient Safety Indicator Public Reporting

Improving patient safety is about creating an environment that is transparent and committed to change. This is the mandate of the government's Patient Safety Initiative.

The government announced public reporting of eight indicators on May 28, 2008 as part of a comprehensive plan to create an unprecedented level of transparency in Ontario’s hospitals. A Public Hospitals Act (PHA) regulatory amendment, effective July 28, 2008, requires hospitals to publicly report on patient safety indicators related to hospital-acquired infections, actions undertaken to reduce such infections, and mortality. Under Regulation 965 of the PHA, hospitals are required to disclose the results of each indicator through their website.

As of 2010 Ontario hospitals publicly report on nine patient safety indicators.  Standardized data elements, case definitions and reporting requirements have been developed for all indicators. The list of patient safety indicators and timeframes for reporting are given below.

Patient Safety Indicator Date of initial Public Reporting Reporting Frequency
Clostridium difficile Infection (CDI) rate Sept. 26, 2008 Monthly
Methicillin-resistant Staphylococcus aureus (MRSA) rate Dec. 30, 2008 Quarterly in January, April, July and October
Vancomycin-resistant Enterococci (VRE) rate Dec. 30, 2008 Quarterly in January, April, July and October
Hospital-Standardized Mortality Ratio (HSMR) Dec. 30, 2008 Annually in December
Ventilator-Associated Pneumonia (VAP) rate April 30, 2009 Quarterly in January, April, July and October
Central Line-Associated Primary Blood Stream Infection (CLI) rate April 30, 2009 Quarterly in January, April, July and October
Surgical Site Infection (SSI) prevention rate in hip and knee joint replacement surgeries April 30, 2009 Quarterly in January, April, July and October
Hand Hygiene Compliance April 30, 2009 Annually in April
Surgical Safety Checklist (SSC) compliance July 30, 2010 Bi-annually in January and July

Other Patient Safety Initiatives

The Ontario government has taken a number of steps to strengthen patient safety in health care institutions across the province.

CDI Outbreak Definition

A Health Protection and Promotion Act regulatory amendment, effective September 1, 2008, makes Clostridium difficile Infection (CDI) a communicable disease designated as reportable. As a result, public hospitals are required to report all cases and outbreaks of CDI to their Public Health Unit.

Hand Hygiene Improvement

Effective December 1, 2011, the Ministry of Health and Long-Term Care completed the transfer of the Just Clean Your Hands (JCYH) program to Public Health Ontario.

JCYH is an evidence-based, multifaceted program established in Ontario in 2008 to improve compliance with hand hygiene best practices in health care settings to prevent healthcare associated infections and promote patient safety. In 2009, JCYH was adapted and rolled out for use in long-term care homes, and launched to retirement homes in 2011.

For more information about the JCYH program, please visit the Public Health Ontario website at

Regional Infection Control Networks

Fourteen Regional Infection Control Networks (RICNs) have been created across the province to promote the best approaches to infection prevention and control. This includes promoting consistent infection prevention and control policies and surveillance practices. Development of the networks has brought together infection prevention and control expertise from all health care settings, including hospitals, public health units, community care centres and long-term care homes.

Infection Prevention and Control Practitioners

The government has provided funding for infection prevention and control practitioners (ICPs) in hospitals across the province. ICPs are typically health care professionals who have specialized training and expertise in infection prevention and control. The ICP works with all departments in an organization to prevent health care-associated infections through planning, implementing, evaluating and providing feedback on current practices. They also educate health care staff on infection prevention and control, conduct surveillance and provide expert consultation as needed.

An extensive education program for infection prevention and control professionals in acute care facilities has been developed by the government in partnership with infection prevention and control experts and other stakeholders. The program provides current, evidence-based educational modules for front-line health care professionals in acute care settings. The modules focus on hand hygiene, chain of transmission and routine practices.

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