What are the accreditation standards in SCI acute and rehab care?
In 2012, RHI partnered with Accreditation Canada (AC) to develop comprehensive and evidence-based standards for spinal cord injury called the Acute and Rehabilitation SCI Standards of Care (SCI Standards), as part of AC's existing Qmentum accreditation program, which hospitals sites already participate in. Implementation of these standards through policy and practice changes will help standardize and optimize care for people with SCI in Canada.
RHI's goal is to have at least 50% of the acute and rehabilitation centres participating in the Rick Hansen SCI Registry (RHSCIR) to use the SCI Standards as part of their organizations' Qmentum accreditation site visits by the year 2018.
RHSCIR sites which have successfully fulfilled the SCI Standards according to Qmentum accreditation as of June 2017. For a complete list of accredited sites to date, see Status.
How the standards were created
In a joint effort with RHI, AC set up a national Spinal Cord Injury Advisory Committee to assist in the development of the SCI Acute and Rehabilitation Accreditation Standards. The Advisory Committee consisted of experts in the field of SCI across the continuum of care. The Standards were piloted in four Canadian centres:
- Glenrose Rehabilitation Hospital, AB (Rehab)
- Ottawa Hospital, ON (Acute and Rehab)
- Capital Health, Halifax, NS (Acute and Rehab)
- Saint John Regional Hospital, NB (Acute)
SCI Standards at a glance
The SCI Standards are comprised of criteria with three different levels of priority:
- Required Organizational Practices (ROPs) address critically important patient safety areas, requiring specific tests of compliance to demonstrate evidence-based practices. ROPs are defined by AC as essential practices (e.g. assessment and management of pressure injuries or medication reconciliation) that must be in place at the time of the site visit, and are subject to a formal follow-up if not met. ROPs have the greatest impact on an organization's overall accreditation award.
- High Priority criteria relate to other important themes of safety, ethics, risk management and quality improvement (e.g. training of team members on proper and safe use of equipment, devices and supplies used in SCI services). High Priority criteria that are unmet at the site visit may be subject to a formal follow up, at the discretion of AC.
- Other criteria usually pertain to enabling systems within the organization that allow clinical teams to perform well on ROPs and High Priority criteria (i.e. having access to the right resources, physical space and information systems).
Supporting hospitals with their accreditation process
RHI is working to encourage and support SCI centres to adopt the SCI Standards as part of their organizations' existing Qmentum process. Accrediting centres with the new SCI Standards will help ensure that individuals with SCI across Canada are receiving the same level of quality care at any SCI centre.
Standardization of care benefits not only patients, but also the health care system overall by reducing unintended variation in care that is not driven by evidence-based practice, thereby making more effective use of resources, improving patients' health outcomes, and reducing the burden on the healthcare system. This project will encourage centres to adopt best practices and policies that reflect the current state of knowledge and evidence-based best practices for SCI care.
RHI has developed a strategy to spread the adoption of the SCI Standards between 2014 and 2018. This strategy consists of a multi-phased approach including promotion and advocacy of the standards to SCI centres, development of practical tools and resources to aid in implementation of the practices described in the standards, and fostering a community of practice to celebrate and share successes. An AC Toolkit -- available on RHI's clinical resource site SCI2 -- has been developed to help support organizations with implementation of the SCI Standards. The toolkit includes an accessible library of resources that clinicians and policy makers can use to change practice (e.g. clinical practice guidelines, pre-printed orders), and frequently asked questions regarding the accreditation process.
Congratulations to the following facilities who have successfully completed the SCI Standards review as part of their Qmentum accreditation process (as of November 2016).
|Queen Elizabeth II Health Sciences Centre, Halifax Infirmary||Acute||Nov 2013|
|Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehab Centre||Rehab||Nov 2013|
|Hôpital du Sacré-Coeur de Montréal||Acute||Apr 2014|
|London Health Sciences Centre, Victoria Hospital||Acute||Nov 2014|
|Toronto Rehab, Lyndhurst Centre||Rehab||Nov 2014|
|Hamilton General Hospital||Acute||Jun 2015|
|Hamilton Regional Rehabilitation Centre||Rehab||Jun 2015|
|Winnipeg Health Sciences Centre||Acute and Rehab||Apr 2016|
|Foothills Medical Centre||Acute and Rehab||May 2016|
|Glenrose Rehabilitation Hospital||Rehab||May 2016|
|Vancouver General Hospital||Acute||Sept 2016|
|GF Strong Rehabilitation Centre||Rehab||Sept 2016|
|Ottawa Hospital Rehabilitation Centre||Rehab||May 2017|
For more resources, information and toolkits to support the adoption of the SCI Standards, see RHI’s clinical resource website (SCI2) at sci2.rickhanseninstitute.org/accreditation-canada and download our one page fact sheet.