Exciting work is currently underway to develop innovative ways to ensure home and community care patients are achieving the best possible results.
CCACs and service provider organizations along with their respective provincial associations, are working together to design, test and implement standardized care pathways for people with similar conditions (e.g. people recovering from hip or knee surgery). These pathways may also link the payment for services to the achievement of specific health outcomes for patients.
What is outcome-based care?
Outcome-based care is a team-based approach to patient care that uses the most current evidence to support decision-making about the care of individual patients.
Outcome-based care focuses on:
- Achieving specific outcomes for people with similar care needs, such as wound healing and better mobility following surgery to the hip or knee
- Applying guidelines for care based on best practices
- Providing the right care at the right time
- Continuous monitoring of quality and efficiency to ensure the best results
How will outcome-based care benefit patients?
Through outcome-based care, patients will have one point of contact who will work to organize their care and ensure a team-based approach. Communication with patients and among health-care providers is key to improving everyone's care experience. Teams will share information more effectively to create a stronger circle of care.
As a result, patients and caregivers will only need to tell their story once, and have a key contact to answer questions and provide support to them. With all partners working as a care team, patients and caregivers will experience a smooth transition between care settings, such as hospital to home.
Working as one team, patients and their families can make more informed care decisions together. Plans for each patient's care will be developed based on their specific needs, with their input, including setting goals (or desired results) and reviewing treatment outcomes.
Two key elements of outcome-based care include:
- Outcome-based Pathways (OBPs) - OBPs outline specific evidence-based outcomes to guide the plan of care for specific patient populations. For example, OBPs have been developed to address the needs of patients requiring wound care, recovering from hip or knee surgery, and those with palliative care needs. With time, and as we learn more, additional patient populations will be added to this work, such as individuals who have had a stroke or congestive heart failure.
- Outcome-Based Reimbursement (OBR) – OBR links the payment of care to the achievement of patient-based health outcomes for home and community care patients.