Child & Youth Health Indicator Program

The Canadian public and policy-makers alike have recognized the need to address
gaps, inequities and the very sustainability of the Canadian healthcare system. Several large scale commissions reviewed the state of healthcare in Canada, consulted with the public and key stakeholders and have presented their recommendations (Kirby, 2001, 2004; Romanow, 2002). A common theme has emerged – the need for indicators to provide accurate assessments of the state of the nation’s health, to evaluate the impact of policy, service and other interventions and to address the critical issue of accountability.

Our knowledge of the status of the health and healthcare of our children and youth is seriously hampered by the lack of nationally validated indicators!

The Coalition launched the Indicator Program in 2004: “To identify existing indicators and develop new indicators that will be used to monitor and evaluate the health of, and the health services provided to, infants, children, youth and their families. The aim is to improve services and, thereby, the health and wellbeing of infants, children, youth and their families”.

Over 200 Canadian research, clinical experts and administrators have participated in the creation of the CCYHC Indicator Program!

Six expert panels were created, harnessing the expertise of over 80 professionals from coast-to-coast: Patient Safety, Injury Prevention/Trauma, Mental Health, Primary Care, Chronic Conditions and Efficiency. Borrowing from the CIHI / Statistics Canada Indicator Framework, each Panel identified key questions that needed to be addressed to advance the health and healthcare of Canadian infants, children and youth, reviewed the literature for existing indicators and recommended the development of new indicators with a focus on future research. Potential partners and funding sources were also identified.

A Steering Committee was then created, comprised of the co-chairs of the six Expert Panels and key partner organizations - the Canadian Institute of Health Information (CIHI), the Canadian Institutes of Health Research (CIHR), the Canadian Council on Health Services Accreditation (CCHSA) and the Public Health Agency of Canada. With input from an expert consultation community of over 100 health researchers, practitioners, administrators, and decision-makers a “Strategic Pathways” plan was developed to transform the Expert Panels’ visions and recommendations into concrete strategies that could yield both immediate successes and long term impact.

Indicators Strategic Pathways

Immediate Uptake of Selected Existing Indicators

The uptake of indicators is a primary objective of the CCYHC Indicator Program. Where indicators exist, and are valid, and reliable, uptake by organizations like CCHSA, CIHI and others can provide a powerful mechanism for advancing national paediatric health service standards. This pathway can yield immediate concrete results with long term impact.

Work is currently underway with CCHSA to identify and incorporate a number of the indicators identified by the Expert Panels. The focus at this time is on patient safety with a plan to incorporate other valid indicators as CCHSA’s indicator program grows.

Development of an RFA for “Child and Youth Health Indicator Development and Validation

What an RFA can do to advance the objective of establishing valid indicators:

• Ensure the empirical basis of new and validated indicators
• Broaden the research base and national audience far beyond the academic health care setting, e.g. the primary care world, Aboriginal community, community health agencies, education sector, policy analysts, social agencies, philanthropic organizations…
• Allow the “content experts” to validate a process that will allow for system-wide change
• Help build Canadian standards for our children & youth!

Six priority areas have been identified:

• Chronic Conditions
• Disabilities
• Injury
• Mental Health
• Patient Safety
• Primary Care

The following cross-cutting themes have been identified:

• Access to care – Wait times
• Adverse events
• Burden of illness/care
• Effectiveness of care/outcomes
• Efficiency of resource use
• Health care utilization
• Quality and safety of care
• Uptake of guidelines and treatments
• Uptake of indicators and impact

Areas of focus within the six identified priorities:

• How can we reliably measure wait lists and their impact on prognosis and outcome, including those for the family and the healthcare system? 
• How can we measure the burden of illness and burden of care for infant, children and youth with different conditions at different developmental stages, in different cultural groups and geographic regions?
• How can we measure well-being and resilience in infants, children and youth and their families with respect to health, i.e., physical, mental and social well-being? 
• How can we measure the uptake of condition-specific care guidelines and evidence-based treatments for different conditions and the impact these have on quality of care, healthcare utilization and health outcome?
• How do we identify and measure the determinants of health care utilization across the continuum of care? How do we measure “inequality” within the system and its impact on health and system outcomes?
• How can we measure the current health resources being expended on infants, children and youth across the continuum of care? 
• How do we measure safe health care?
• How can we measure the uptake of indicators and the impact of their utilization on the healthcare system and health outcomes? How can we measure quality improvement?

Infant, child and youth health and healthcare indicators is CCYHC’s first national priority!

The Canadian Child & Youth Health Coalition has established the framework for significantly advancing our capacity to utilize research to answer the important health and health care issues facing Canadian infants, children, youth and their families. The development, validation and application of paediatric indicators underpin empirically based decision making at all levels of health/care – the individual, the practitioner, the administrator, the policy-maker.

View our "Development Documents" section to learn more about the CCYHC Indicators Program.

Click here for addtional information about the CCYHC CIHR Child and Youth Health Indicators RFA