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NRS eReports Manual: User Guide & Report Interpretation

1. Gel al GS aa Categories 50 Series 10 Icons from left to right Save Save your result as a report template or filter Undo Undo the most recent action Redo Redo the most recent action Grid View report in grid format Graph View report in graph format Grid and Graph View report data in both grid and graph formats Graph Type Select a graph type Graph Subtype Select a graph subtype Legend Display legend on the graph Data Values Display data values on the graph Series by Row Display series by rows Series by Column Display series by columns Auto Arrange Automatically repositions components of your graph in an attempt to fix overlapping elements or those currently being displayed with incorrect spacing Categories Specify number of data values to be displayed on one graph page Series Specify number of bars on the graph representing different data values of the same attribute element Apply Apply the formatting change s to the graph For more information about graph formatting refer to Section 7 4 Format Toolbar Figure 7 7 The Format Toolbar Home Tools Data Grid Graph H Ao Oh tl BR B scac votes aral ri Bz oD sho 8 98 fuZ Al l s eL o t Icons from left to right Save Save your result as a report template or filter CIHI 2015 38 NRS eReports Manual User Guide and Report Int
2. Added ASIA Impairment Scale as an attribute AR AP Sept 2012 MicroStrategy upgrade to version 9 3 Includes minor changes to appearance of reports and Throughout Jan 2013 use of toolbars Added Clients Home Prior to Admission AR OD Sept 2014 COUNTY as a metric Legend AR Analytical Reports CR Comparative Reports QI Quick Indicators AP Admission Profile reports OD Outcomes at Discharge reports OF Outcomes at Follow up reports RU Resource Utilization reports CIHI 2015 149 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Appendix D Notes for CIHI Portal Users This section is specific to users of the CIHI Portal ad hoc reporting product Introduction Working within CIHI Portal s dynamic web based environment registered users from Canada s data submitting health care organizations such as hospitals regional health authorities and ministries of health are able to explore and answer today s health care questions like never before The inclusion of NRS data in the CIHI Portal environment means that Portal subscribers can access existing NRS eReports and or create ad hoc NRS reports The NRS Environment The National Rehabilitation Reporting System NRS was developed by CIHI in 2001 to support data collection by hospitals for inpatient rehabilitation clients who are mainly age 18 and older The rehabilitation services are provided i
3. Multiple Facilities Outcomes at 1 Outcomes at Follow Up Any attributes Follow Up Peer Comparisons 2 Outcomes at Follow Up Multiple Facilities Resource 1 RPG Case Mix and Functional Status Any attributes Utilization Peer Comparisons 2 RPG Case Mix and Functional Status Multiple Facilities RPG Patient Days Peer Comparisons 4 RPG Patient Days Multiple Facilities Peer RCG Information Report Peer Information Report for Facilities Submitting Follow up Data CIHI 2015 135 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 N ps 74 NRS 4 Average Days Waiting for Admission Across RCGs eReports 2 Average Admission Total Function Score Across RCGs GC g 3 Average Discharge Total Function Score Across RCGs a 4 Average Change in Total Function Score Across RCGs 5 Average Days Waiting for Discharge Across RCGs Quick Indicators 6 Average Length of Stay LOS Across RCGs 7 Average Length of Stay LOS Efficiency Across RCGs AS y 8 Percent Discharged Home Who Were Home Prior to Admission Across RCGs 9 Average Follow Up Total Function Score Across RCGs 10 Data Quality Indicators C p 4 ae Ny 1 Admission by Referral Source a x 2 Admission by Rehabilitation Client Group ia 3 Admission by Admission Class Admissions 4 Admission by Pre Hospital Living
4. code 2 Boarding house code 3 Assisted living code 4 Residential care code 5 Shelter code 6 Public place code 7 Other code 8 Unlike the Follow Up Living Arrangements data element each client can only be coded into one living setting and therefore only appears once in the calculation CIHI 2015 77 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Inclusions exclusions Response codes 50 Not available and 70 Unknown are included in the denominator for percentage calculations Interpretation considerations This indicator along with Follow Up Living Arrangements provides information on the home environment at the time of follow up and can be compared to the post discharge environment indicators in the measurement of outcomes Most Responsible Health Condition ICD 10 CA Chapter Available in e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge Describes the distribution of clients by etiological diagnoses at admission based on the response choice for data element 80 Most Responsible Health Condition ICD 10 CA For reporting purposes the response choices have been grouped by ICD 10 CA Chapter Codes For further granularity the indicator can be drilled down to the level of ICD 10 CA Rubric or to the level of the individual ICD 10 CA codes Number of Beds Available in e All NRS Comparative Reports and NRS Analytical Repo
5. 2 From here you have several options a Remove a particular report Check the box to the right of the report of interest and click Remove View a report s details Click on blue information icon Export a report as a PDF document Click the PDF icon Export a report as an Excel HTML or plain text document Click the Export icon View a report Click the report name hyperlink f Rename a report Click the Rename icon and then give the report a new name oao 4 7 Preferences Select the Preferences page to access user settings and preferences This page allows you to customize how your NRS eReports system appears and behaves This feature is similar to the Options menu item in many Microsoft programs Note that many of the available options are designed for advanced users only The left side of the Preferences page provides links to all categories of user preference parameters To apply any changes you make simply click on the Apply button at the bottom of the page You have the option of making changes to the NRS eReports environment specifically or to all of the eReports environments you have permission to access The following are Preferences categories General Change the default page that appears when you log in and select your time zone CIHI 2015 12 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Folder browsing This feature is currently deactivated for NRS eReports us
6. The calendar date that the client is considered ready for discharge from the rehabilitation program On this date the client meets criteria for discharge according to the rehabilitation team and has met all or most of the rehabilitation goals set for them CIHI 2015 138 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Days Waiting for Admission One of the NRS indicators relating to accessibility Defined as the number of days between the Date Ready for Admission and the Date of Admission to rehabilitation Discharge FIM instrument Assessment The assessment of the client s functional ability using the FIM instrument at discharge The FIM instrument should be administered within 72 hours before discharge from the rehabilitation program Dressing Lower Body FIM instrument Includes dressing and undressing below the waist as well as applying and removing a prosthesis or orthosis when applicable Includes all items of clothing that are typically worn The client must use clothing that is appropriate to wear in public Assessment starts in front of the closet or dresser drawers and includes reaching for items of clothing Dressing Upper Body FIM instrument Includes dressing and undressing above the waist as well as applying and removing a prosthesis or orthosis when applicable Includes all items of clothing that are typically worn The client must use clothing that is appropriate to
7. instrument elements 18 to 126 CIHI CIHI Cognitive Score All CIHI cognitive elements 7 to 30 CIHI 2015 68 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 12 In Depth NRS Analytical Reports For a list of available reports and where to find them refer to Appendix A For a list of some common terminology used in describing reports refer to Chapter 5 e Attributes Metrics RCG RPG And more For a complete list of all terms used in NRS eReports refer to Appendix B 12 1 Overview Analytical Reports are build your own reports that allow even greater flexibility than Quick Indicators or Comparative Reports but which require a bit more time and effort to produce than the other two types of reports As with Comparative Reports Analytical Reports are divided into four major categories Unlike Comparative Reports however Analytical Reports allow you to display data based on ANY available metrics and attributes Each Analytical Report will prompt you for Facility or Facilities Fiscal Year s and RCG s and then will allow you to select your desired metrics and attributes You will be prompted with a list of attributes and metrics associated with admissions discharges follow ups or resource utilization to display on the report Half of the Analytical Reports will also allow you to select a peer group using the same three Peer prompts that are available in the Compara
8. 2 1 RPG Case Mix and Functional Status Peer RCG Information l Peer Comparisons Report X Resource ll 2 RPG Case Mix and Functional Status Se a Utilization Multiple Facilities wit s 3 RPG Patient Days Peer Comparisons Peer Information Report 4 RPG Patient Days Multiple Facilities for Facilities Submitting NS y Follow up Data CIHI 2015 136 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Appendix B NRS Glossary Terms related to the National Rehabilitation Reporting System NRS are taken from the Rehabilitation Minimum Data Set Manual RMDSM which is updated annually and distributed by the Canadian Institute for Health Information Refer to the RMDSM for context specific information related to these terms A Active Rehab Length of Stay The number of days between the date on which the client is admitted to the rehabilitation facility and the date on which the client is ready to be discharged from the rehabilitation facility Any days on which the client could not participate in the rehabilitation program due to a health reason are excluded from the calculation see Service Interruption Active Rehab Length of Stay Efficiency The change in Total Function Score see Total Function Score per day of client participation in the rehabilitation program Calculated as the change in Total Function Score from admission to discharge divided by the active rehab
9. Average Mean OD Standard Deviation OD Minimum OD Maximum OD CIHI 2015 96 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Table 14 2 Availability of Function Score and CIHI Cognitive Score metrics across NRS eReports Report sub types are abbreviated as follows AP Admissions Profile OD Outcomes at Discharge OF Outcomes at Follow Up RU Resource Utilization cont d NRS Quick NRS Comparative NRS Analytical Indicators Reports Reports Transfer Function Score at Admission Average Mean AP OD Standard Deviation AP OD Minimum AP OD Maximum AP OD Transfer Function Score at Discharge Average Mean OD Standard Deviation OD Minimum OD Maximum OD Transfer Function Score Change Average Mean OD Standard Deviation OD Minimum OD Maximum OD Locomotion Function Score at Admission Average Mean AP OD Standard Deviation AP OD Minimum AP OD Maximum AP OD Locomotion Function Score at Discharge Average Mean OD Standard Deviation OD Minimum OD Maximum OD Locomotion Function Score Change Average Mean OD Standard Deviation OD Minimum OD Maximum OD CIHI 2015 97 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Table 14 2 Availability of Function Score and CIHI Cognitive Score metrics across NR
10. Axes This tab allows you to make changes to the look of the graph axes such as altering the maximum and minimum values or specifying the size of grid intervals Advanced This tab includes advanced options such as defining the series to be used in the graph font and line resizing and showing of subtotals CIHI 2015 42 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 How to format a graph 1 Click the Graph icon on the menu bar to display the report in graph view 2 Open the Format drop down menu 3 Select Graph 4 Select the General Format Number Axes or Advanced tab 5 Define the preferred formatting options 6 Click Apply 7 Click OK 7 5 Data Manipulation There may be times that you want to reorganize the way information is displayed and aggregated on a report without actually changing the overall content Data manipulation can help to highlight a particular issue or trend that may not have been as clear when the report attributes were displayed in a previous configuration There are three ways to move data such as attributes or metrics around in a report e Clicking on the object s header and dragging it to a new location e Right clicking on the object s header and selecting Move e Displaying Pivot Buttons by selecting Pivot Buttons from the Tools menu The pivot buttons will display beside the object s headers and can then be used to move them to anothe
11. Firefox 2 0 For Mac OS X Safari 3 1 1 Web Reporter only For iPhone iPhone packaged Safari browser Web Reporter only At a minimum you should have one of the following for a Windows operating system Microsoft Internet Explorer version 6 0 SP1 6 0 SP2 or 7 0 Firefox 2 0 Browser resolution Minimum resolution for the monitor is 800 x 600 or higher with 256 color palette minimum but the recommended resolution is 1024 x 768 or higher Spreadsheet export Microsoft Excel or other spreadsheet application that supports the CSV application file type PDF viewer for viewing and Adobe Acrobat Reader versions 6 7 8 or 8 1 exporting PDF documents Adobe Flash Player Adobe Flash Player 9 0 or higher CIHI 2015 5 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 2 2 Obtaining Access The NRS eReports system is restricted to authorized users Before you can view the reports a CIHI Client Services profile must be created and NRS eReports access granted to that account Please write to nrs cihi ca if you require access Please note that all requests for access must be received from the facility s Facility Coordinator as listed on the Facility Profile 2 3 Logging in From the CIHI Website To get to the NRS eReporting system O 1 Go to www cihi ca and click on Applications in the top menu bar 2 Click eReporting 3 Enter your Client Services username and password and click the L
12. Outcomes at Discharge NRS Analytical Reports gt Outcomes at Follow up NRS Analytical Reports gt Resource Utilization The difference between elements 29 Date Ready for Discharge and 21 Admission Date for all records submitted It describes the average period of time in days that clients are considered to be in active rehabilitation at the facility peer and national levels As such service interruptions and days waiting for discharge are not included Requires completion of element 21 on the admission assessment and elements 25A B Service Interruption Dates if applicable and 29 on the discharge assessment Inclusions exclusions Date Ready for Discharge is mandatory to record if element 31 Reason for Discharge is coded as 1 or 2 Goals met and client discharged transferred otherwise it is optional to record As of December 2011 Active Rehab LOS is calculated using element 30 Discharge Date in cases where the Date Ready for Discharge element is left blank This ensures that each client for whom LOS is calculated will also have an Active Rehab LOS calculated and ensures that the two indicators are based on the same number of people Prior to December 2011 records had been excluded from this indicator when the Date Ready for Discharge element was left blank Active Rehab LOS will always be less than or equal to the LOS indicator as it removes any discharge wait time that might exist Interpretation considerations This indicator can
13. Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Follow Up The number of days between 20B Date Ready for Admission and 21 Admission Date This is one of the NRS indicators pertaining to accessibility of rehabilitation services Inclusions exclusions Excludes admission records where element 20A Date Ready for Admission Known 0 No Interpretation considerations Due to the option of indicating that Date Ready for Admission is not known the number of records included in this calculation may be smaller than the overall number of records included in the report Care should be taken when interpreting this indicator as being representative of the entire inpatient rehabilitation population The Days Waiting for Admission indicator does not provide specific reasons for delays in admission to rehabilitation Facilities wishing to track this indicator more closely may consider independently tracking specific reasons for delays in the admission process A median value and an average value are provided for the Days Waiting for Admission to Rehabilitation indicator Refer to the Average Onset Days indicator for information about comparing medians and averages Available metrics count average mean median 25th percentile 75th percentile Days Waiting for Discharge Available in e NRS Quick Indicators gt 5 Average Days Waiting for Discharge Across RCGs CIHI 2015 111 NRS eReports Manual User Guide and Report Interpretation
14. Standard Deviation OF OF Motor Function Score Change Average Mean OD OD Median OD Standard Deviation OD OD Minimum OD Maximum OD Cognitive Function Score at Admission Average Mean AP OD OF AP OD OF Median AP OD OF AP OD OF Standard Deviation AP OD OF AP OD OF Minimum AP OD Maximum AP OD Cognitive Function Score at Discharge Average Mean OD OF OD OF Median OD OF OD OF Standard Deviation OD OF OD OF Minimum OD Maximum OD Cognitive Function Score at Follow Up Average Mean OF OF Median OF OF Standard Deviation OF OF CIHI 2015 94 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Table 14 2 Availability of Function Score and CIHI Cognitive Score metrics across NRS eReports Report sub types are abbreviated as follows AP Admissions Profile OD Outcomes at Discharge OF Outcomes at Follow Up RU Resource Utilization cont d NRS Quick NRS Comparative NRS Analytical Indicators Reports Reports Cognitive Function Score Change Average Mean OD OD Median OD Standard Deviation OD OD Minimum OD Maximum OD CIHI Cognitive Score at Admission Average Mean AP OD OF AP OD OF Median AP OD OF AP OD OF Standard Deviation AP OD OF AP OD OF Minimum AP OD Maximum AP OD CIHI Cognitive Score at Discharge Average Mean OD OF OD OF
15. Toilet Transfer and Tub Shower Transfer Available metrics average mean standard deviation minimum maximum Locomotion Function Score at Admission Available in e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge The sum of the scores on admission for the FIM instrument motor items that assess locomotion Walk Wheelchair and Stairs Available metrics average mean standard deviation minimum maximum Locomotion Function Score at Discharge Available in e NRS Analytical Reports gt Outcomes at Discharge CIHI 2015 128 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 The sum of the scores on discharge for the FIM instrument motor items that assess locomotion Walk Wheelchair and Stairs Available metrics average mean standard deviation minimum maximum Locomotion Function Score Change Available in e NRS Analytical Reports gt Outcomes at Discharge The difference between the scores on discharge and admission for the FIM instrument motor items that assess locomotion Walk Wheelchair and Stairs Available metrics average mean standard deviation minimum maximum Communication Function Score at Admission Available in e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge The sum of the scores on admission for the FIM instrument cognitive items that assess communi
16. labels or none at all Most commonly RCG is listed in the Page By axis but you can cause any of the attributes or metrics included in your report to be used in the Page By axis See Section 7 1 for more information about the Page By axis Common Functionality All of the different Comparative Reports share the following functionality CIHI 2015 63 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 1 Data in reports is available for the most recent six fiscal years Since the most recent fiscal year may still be in progress that year will effectively contain year to date data only 2 Users choose the method for creating peer groups for comparisons Peer grouping is based on facility type general or specialty or number of beds or facility name s number s 3 Users can drill into the data such as from fiscal year to fiscal quarter Users are able to save or export any Comparative Report 5 Filter details describing which data was chosen for the report will be displayed above the report by default gt A 11 2 Attributes and Metrics Available in NRS Comparative Reports The attributes that are available in the different NRS Comparative Reports are listed in Table 13 1 in Chapter 13 For attribute definitions inclusion exclusion criteria and interpretation considerations refer to Section 13 2 The metrics that are available in the different NRS Comparative Reports are listed in tables 14 1
17. 17 health condition groups known as Rehabilitation Client Groups RCGs The RCG selected for a particular client is based on the condition that best describes the primary reason for the client s admission to the inpatient rehabilitation unit or facility for example stroke or limb amputation Some RCGs are further divided into subgroups in order to facilitate more specific analysis of groups that contain large numbers of rehabilitation clients for example left and right sided strokes Some NRS eReports contain only the 17 major groups while others include subgroups For more information about RCGs refer to Chapter 13 5 5 Rehabilitation Patient Groups The NRS now includes a case mix grouping methodology known as the Rehabilitation Patient Group RPG methodology The RPGs have cost weights associated with them and explain variance in length of stay and other NRS variables of interest to a greater extent than the FIM Function Related Groups FIM FRGs and other methodologies based on the FIM instrument They represent a natural transition to a Canadian grouping methodology for inpatient rehabilitation For more information about RPGs refer to Chapter 13 5 6 Metrics This term refers to the numerical data such as percentages counts N or a variety of summary statistics for example average median standard deviation that summarize each of the demographic clinical and administrative indicators available in NRS eReports for
18. 58 inclusive that assess various components of cognitive function communication social interaction problem solving etc at the time of admission The Cognitive Function Score ranges from 5 to 35 and provides a score that describes a client s cognitive function based on the elements tested Inclusions exclusions Cognitive Function Score is calculated from admission records containing complete FIM instrument Total Function Scores that is both motor and cognitive components Records for which no FIM instrument assessment has been completed for example records with Admission Class 4 Un planned Discharge are excluded Interpretation considerations The Cognitive Function Score isolates the cognitive components of the FIM instrument and allows for a better comparison of cognitive function between FIM instrument assessments Available metrics average mean median standard deviation minimum maximum Cognitive Function Score at Discharge Available in e NRS Comparative Reports gt Outcomes at Discharge gt 2 Functional Status at Admission and Discharge From Facility CIHI 2015 122 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 e NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up e NRS Analytical Reports gt Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Follow Up This is the sum of the five FIM instrument elements 5
19. 64 to 69 on the follow up assessment Inclusions exclusions Includes all records for ages older than 13 where element 19A Admission Class is initial rehabilitation continuing rehabilitation short stay or readmission class and element 63 Presence of Cognitive Communication Activity Limitations is coded as Yes and element 79 Glasses Hearing Aid Flag is coded as No or left blank Interpretation considerations CIHI Cognitive elements with a score of 8 are recoded as 1 for the purposes of this calculation The CIHI Cognitive Score at Follow Up can be compared at the facility peer and national levels or to the CIHI Cognitive Score at Discharge for that facility The score can be considered along with indicator distributions such as Rehabilitation Client Group Reason for Discharge Discharge Living Setting and Arrangement to give a clearer picture of the typical discharge situation for a rehabilitation client Available metrics average mean median standard deviation CIHI Cognitive Score Change Available in e NRS Comparative Reports gt Outcomes at Discharge gt 2 Functional Status at Admission and Discharge From Facility e NRS Analytical Reports gt Outcomes at Discharge Describes the average change in CIHI Cognitive Scores from admission to discharge for all records submitted This is the difference between the admission CIHI Cognitive Score and discharge CIHI Cognitive Score for each client episode averaged for all episodes Requ
20. Analytical Reports Facilities Submitting Follow up Data istrator U Owner Ac ui f Res Peer RCG Information Report Owner Administrator D Modified 11 26 View u 5 AM f r information regarding ion and ting data to sed to aid users in The Shared Reports folder also contains a User Defined NRS eReports shared access folder which permits users to create save and share reports with other NRS eReports users CIHI 2015 10 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 4 5 My Reports Select the My Reports option from the CIHI Projects Dropdown Menu to access the My Reports folder which contains reports that you specifically have created and saved Sub folders can also be created here to organize your reports Reports in this folder are specific to your profile and are not accessible to other users The My Reports folder may be convenient if you have certain reports that you create and access regularly if they are saved here you won t have to start from scratch each time 4 6 History List Select the History List option from the CIHI Projects Dropdown Menu to access the History List folder The folder contains a listing of all of the reports that you have created and explicitly added to the History List You can add reports to the History List by clicking the Add to History List link on the Wait Page or on the Home drop down menu on the Report screen Reports in the Histor
21. Arrangements Profile 5 Admission by Pre Hospital Living Setting Xa J 6 Age at Admission to Facility 7 Functional Status at Admission to Facility N va ae N Zz 1 Client Demographics 2 Functional Status at Admission and Discharge Outcomes at L y From Facility Discharge 3 Clinical Outcomes at Discharge j 4 Discharge Destination we 5 Length of Stay and Service Interruptions J __ I Comparative N 4 Follow Up Living Arrangements Reports 2 Follow Up Living Setting g AEN a Outcomesat y 3 Client Follow Up Count Follow Up 4 Functional Status at Follow Up 5 Clients Achieving Partial or Full Community N gt Re Integration Se 7 W A 7 N 1 RPG Patient Days Report X Resource 2 RPG Patient Days Report Most Recent Quarter D Utilization 3 RPG Case Mix Report Original Methodology 4 RPG Case Mix Report Current Methodology SS 5 Functional Status Gain by RPG aa 6 Regional Case Mix Report Original Methodology a 7 Regional Case Mix Report Current Methodology J Admissions p A Profile 17 Admissions Profile Peer Comparisons P 2 Admissions Profile Multiple Facilities J A Outcomes at 4 Outcomes at Discharge Peer Comparisons Analytical Discharge 2 Outcomes at Discharge Multiple Facilities Reports es Be Ne Ba Outcomes at 41 Outcomes at Follow Up Peer Comparisons Follow Up gl 2 Outcomes at Follow Up Multiple Facilities J Na 2 7 A 7 N
22. Comparative Reports gt Outcomes at Discharge gt 2 Functional Status at Admission and Discharge From Facility NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up NRS Analytical Reports gt Admissions Profile NRS Analytical Reports gt Outcomes at Discharge NRS Analytical Reports gt Outcomes at Follow Up Requires completion of all CIHI Cognitive elements 64 to 69 on the admission assessment Inclusions exclusions Includes all records for ages older than 13 where element 19A Admission Class is initial rehabilitation continuing rehabilitation short stay or readmission class and element 63 Presence of Cognitive Communication Activity Limitations is coded as Yes and element 79 Glasses Hearing Aid Flag is coded as No or left blank Interpretation considerations CIHI Cognitive elements with a score of 8 are recoded as 1 for the purposes of this calculation The CIHI Cognitive Score at Admission can be compared at the facility peer and national levels or to the CIHI Cognitive Score at Discharge for that facility Available metrics average mean median standard deviation minimum maximum CIHI Cognitive Score at Discharge Available in e NRS Comparative Reports gt Outcomes at Discharge gt 2 Functional Status at Admission and Discharge From Facility e NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up e NRS Analytical Reports gt Outcomes at Di
23. FIM instrument that is collected between 80 and 180 days after discharge from the rehabilitation program G General Rehabilitation Facility A facility that provides inpatient rehabilitation services in designated units programs or beds within a general hospital that has multiple levels of care i e rehabilitation acute care chronic care emergency Rehabilitation clients receive multi dimensional physical cognitive psycho social diagnostic assessment treatment and service planning interventions Grooming FIM instrument Includes a minimum of four activities 1 oral care 2 hair grooming combing or brushing hair 3 washing the hands 4 washing the face and may include a fifth activity either shaving the face or applying make up where applicable Washing includes rinsing and drying H Health Care Number The client s health insurance number as assigned by the provincial territorial government of residence I Impact of Pain A self report item describing the impact of pain on a client s daily activities This is one of two self report data elements collected for the NRS Initial Rehabilitation One of the available options for coding Admission Class in the NRS describes a client s first admission to an inpatient rehabilitation facility for a particular rehabilitation condition see Rehabilitation Client Group J K L Length of Stay LOS The number of days between the date on which the
24. For example if there was an admission in Q3 and the person was discharged in Q4 both the admission record for Q3 and discharge record for Q4 would be submitted in Q4 Note In order to ensure a valid submission the admission records must be submitted and accepted prior to submitting the discharge records Assessments that occur in different quarters must be submitted in separate files at the time of submission as submission files are coded according to the quarter in which corresponding assessment records occurred Implications for reporting Facilities using Option 2 will not have any open admission records that is they will have both an admission and corresponding discharge record A possible drawback to using Option 2 is CIHI 2015 53 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 that you will not be able to view up to date admission related data instead having to wait until the corresponding discharges occur Implications for all Facilities Regardless of Option Chosen The use of two different methods by facilities may result in different populations being included in Admissions Profile and Outcomes at Discharge reports The former will include admissions with or without complete discharge records for facilities choosing to submit under Option 1 whereas they will include only admissions with complete discharge records for facilities choosing Option 2 Discrepancies in Total Numbers Report
25. Guidelines April 2015 e NRS Comparative Reports gt Outcomes at Discharge gt 5 Length of Stay and Service Interruptions e NRS Analytical Reports gt Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Follow Up The number of days from element 29 Date Ready for Discharge to element 30 Discharge Date The Days Waiting for Discharge indicator describes the average number of days between the date that the client is deemed ready for discharge from the rehabilitation program and the date that he or she is formally discharged Inclusions exclusions Excludes records where element 29 Date Ready for Discharge is not completed This element is mandatory to code when data element 31 Reason for Discharge is coded as 1 or 2 goals met and client discharged transferred otherwise it is optional to record Interpretation considerations This indicator does not provide specific reasons why delays may exist in discharge from rehabilitation Facilities wishing to track this indicator more closely may consider independently tracking specific reasons for delays in the discharge process A median value and an average value are provided for the Days Waiting for Discharge From Rehabilitation indicator Refer to the Average Onset Days indicator for information about comparing medians and averages Available metrics average mean count median 25th percentile 75th percentile Length of Stay LOS Available in e NRS Quick Indicators g
26. NGD To resize columns and rows 1 Open the Format drop down menu 2 Select Resize Columns and Rows 3 Define the desired size 4 Click OK Autostyles Autostyles are a formatting shortcut that allows a custom report format to be defined and then quickly applied to any grid report Autostyles allow quick formatting of e Colours e Fonts and sizing e Merged row or column headers and e Banding Autostyles can be applied from the Grid toolbar Experiment with different Autostyles and see which ones you might want to use for different report types For example Monochrome works well for simple cross tab reports and Squares automatically merges cells with the same attribute values How to apply Autostyles 1 Display the report in grid view 2 Click Autostyles drop down list on Grid toolbar 3 Select the desired Autostyle CIHI 2015 41 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 7 4 Graphing a Report Once a report of your choice has been generated the data may be viewed as a graph by selecting the Graph or Grid and Graph icons from the toolbar on your screen The Graph icon will convert the data in the report to a graph Grid and Graph will allow you to see the graph with the accompanying data table underneath Selecting Graph or Grid and Graph from the Home drop down menu will achieve the same results The default graph that appears is a vertical bar graph dis
27. O CIHI s RPG Grouping Methodology document available from the CIHI website at www cihi ca casemix Report 5 is the Functional Status Gain by RPG report This report examines the changes from admission to discharge in average Total Function Score and Function Score domain scores as well as CIHI Cognitive scores for each RCG subgroup The domain scores further divide the Motor Function and Cognitive Function sub scales into more comparable groups The report includes records with complete admission and discharge pairs The various Function Score domains and CIHI Cognitive scales that appear in this report are indicated below CIHI 2015 67 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Data Elements in Function Score and CIHI Cognitive Scale Data Elements Included Sub Scale Domain FIM Self Care Function Eating Grooming pag Dressing Upper eee and Lower Body Toileting FIM Sphincter Function Bladder Management Bowel Management 2 to 14 FIM Transfer Function Bed Chair Toilet Tub Shower 3 to 21 FIM Locomotion Function Locomotion Stairs 2 to 14 FIM Motor Function All FIM instrument motor elements 13 to 91 FIM Communication Function Expression Comprehension 2 to 14 FIM Social Cognition Function Social Interaction Problem Solving Memory 3 to 21 FIM Cognitive Function All FIM instrument cognitive elements 5 to 35 FIM Total Function Score All FIM
28. Outcomes at Follow Up RU Resource Utilization Report numbers are shown for Quick Indicators and Comparative Reports cont d NRS Quick NRS Comparative NRS Analytical Indicators Reports Reports Patient Days Count of Clients RU 1 2 RU 3 4 Count of Days RU 1 2 RU 3 4 Post Admit Comorbid Health Condition ICD 10 CA Count OD Pre Admit Comorbid Health Condition ICD 10 CA Count AP OD Sex Percent OD 1 Total Service Interruptions Count OD 1 OD OF Total Service Interruption Days Average Mean OD5 OD OF Standard Deviation OD OF Minimum OD OF Maximum OD OF Count OD Weight kg at Admission Average Mean OD 1 AP OD Median AP OD Standard Deviation AP OD Minimum AP OD Maximum AP OD 25th Percentile AP OD 75th Percentile AP OD CIHI 2015 92 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Table 14 2 Availability of Function Score and CIHI Cognitive Score metrics across NRS eReports Report sub types are abbreviated as follows AP Admissions Profile OD Outcomes at Discharge OF Outcomes at Follow Up RU Resource Utilization NRS Quick NRS Comparative NRS Analytical Indicators Reports Reports Total Function Score at Admission Average Mean QI 2 AP O
29. Reports Current Methodology values are based on the current rehabilitation cost weights and outlier trim points being used in the RPG Case Mix Methodology visit www cihi ca casemix for more information on values that are currently being used Original Methodology values for a particular fiscal year are based on the rehabilitation cost weights and outlier trim points that were in effect during that fiscal year The Current Methodology values permit users to analyze trends over time whereas the Original Methodology values permit users to view the data that would have been seen in reports created in those fiscal years D Date of Onset The calendar date of onset of the main rehabilitation condition coded under Rehabilitation Client Group see Rehabilitation Client Group that precipitated the admission into rehabilitation For acute conditions the date of onset is the date of injury or surgery For chronic condition for example COPD the date of onset is the date of the most recent exacerbation or functional loss that resulted in the admission to the inpatient rehabilitation unit Date Ready for Admission The date on which the client meets criteria for admission to the rehabilitation facility and is considered ready to start a rehabilitation program It does not refer to the date the client is put on a waiting list if this is done prior to when the client is clinically ready for rehabilitation Date Ready for Discharge
30. This value is then averaged over all discharge records CIHI 2015 119 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Inclusions exclusions Requires completion of elements 41 to 58 on both the admission and discharge assessments Interpretation considerations The same absolute change in score among clients with low and high function scores on admission will result in a greater percent change in function among those with low scores compared to those with high scores In other words this is a more sensitive indicator for low functioning client groups compared to higher functioning groups For example an absolute Total Function Score improvement of 20 would result in the following percent changes for two different clients Percent Change Calculation Sample Admission Score Discharge Score Percent Change Low Function Score 20 40 100 40 20 20 High Function Score 80 100 25 100 80 80 In this example the Percent Change value for these two clients would be the average of both percent changes 62 5 25 100 2 Note Percent change should be interpreted carefully The FIM instrument is an ordinal scale rather than an interval scale so the difference between a score of a 2 and a3 on the FIM instrument scale is not necessarily equivalent to the difference between a 4 and a 5 As such a 100 change in a FIM instrument score does not imply that a client h
31. User Guide and Report Interpretation Guidelines April 2015 2 Accessing NRS eReports 2 1 Computer Requirements As the NRS eReports system is web based there are minimum hardware and software requirements for users computers for optimal use Hardware Requirement Minimum Recommended Processor 1 GHz 2 GHz or higher Memory RAM 512 MB 2 GB or higher CIHI 2015 4 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Software Operating system Certified Windows 2000 SP4 all editions on x86 Windows Server 2003 SP2 all editions on x86 Windows XP SP3 all editions on x86 Windows Vista SP1 all editions on x86 Supported Solaris 8 x on SPARC Solaris 9 x on SPARC Solaris 10 x on SPARC AIX 5L Version 5 2 on IBM POWER Architecture AIX 5L Version 5 3 on IBM POWER Architecture AIX 6 1 on IBM POWER Architecture Red Hat Enterprise Linux 3 ES and AS 3 on x86 64 Red Hat Enterprise Linux ES and AS 4 on x86 64 Red Hat Linux Enterprise Linux 5 on x86 64 and Red Hat Linux Enterprise Linux Advanced Platform 5 on x86 64 Oracle Enterprise Linux on x86 64 distributed through the Oracle Unbreakable Linux program SUSE Linux Enterprise Server 9 on x86 64 SUSE Linux Enterprise Server 10 on x86 64 HP UX 11i v2 on Intel Itanium Mac OS X Web browser For UNIX and Linux operating systems Mozilla 1 7
32. admission dates in fiscal year 2008 2009 or later Calculation For episodes that started and ended within the reporting period all days are counted For episodes that started prior to the start of the reporting period and ended within the reporting period days from the start of the reporting period to the discharge date are counted For episodes that started within the reporting period and ended after the reporting period only days from the admission date to the end of the reporting period are counted For episodes that started prior to the reporting period and ended after the reporting period all days within the reporting period are counted Episodes that started prior to April 1 2008 and presently remain incomplete i e no discharge date present do not accrue Patient Days These episodes are considered to be open in error and including them in these calculations would inappropriately inflate the number of Patient Days Inclusions exclusions Includes clients admitted in the reporting period or prior to the reporting period and who continued to receive inpatient rehabilitation services in the reporting period For incomplete episodes that started prior to April 1 2008 Patient Days are not calculated as described further above Interpretation considerations Facilities may want to use this information to make high level comparisons to their MIS statistical data for rehabilitation activity reported to the NRS Post admit Comorbid Health C
33. ahh eae vdedeiceeeenlanee e 21 6 2 Creating NRS Quick Indicator Reports ecccceeeeeeeeeeeeeeeeeeneeeeeeeeeeeteeeneaeeeeeeees 23 6 3 Creating NRS Comparative Reports 0 ceeeeeceecceeeeeeeeeeeeeseaeeeeeeeeeeeesesseaaaeeeeeees 27 6 4 Creating Analytical Reports 2 sscateicetc tick coastneityct a chonatienedaicteenentainneclieeenie 29 6 5 How Do Regenerate a Previously Created Report eeeeeeeeeeeeeeeeeeeeteeeeneees 32 6 6 THOM AN PACS EAEE E TE E AE ade EEE EE ETT 32 7 Modifying and Formatting Reports sseesssesssnereneesseererrrnnrrsserennrrrnnnrssrrrnnrnnnerseet 33 7 1 Report Screen a a e a a A A E 33 7 2 WO OUR zcttec ok E E EE E E EE EE E E 35 7 3 Grid Formatting reena EE E E E 39 7 4 Graphing a Rep T eieaa A ea EE Aa aden cede EA A EEEE E RA EEE eet detente 42 7 5 Data Manipulation ce ae a aa a ae te ae ee teeta aOR eek 43 7 6 SOING A eose e aE n ey secant wen a E cen den E enelten Er ae E E E EARE 44 7 7 Drilinga en e e a a iea e ae EA Aia Pe aE CES 44 7 8 eae E AEA E E E EE EE A E E T 46 8 Saving Exporting and PRATING cox ceecctancte ce eset ea deter es eee Lome ce uletecaads eal we coated 47 8 1 OW 10 Save a Report tesenani tenrian neen eters clea asec etal 47 8 2 Exporting RODOMS assecscese ices a ite tet van E E EEEE EEE REE EAA 48 8 3 How to Print SOO ie se ae eae aS es oe eeee re weed eueneae oe ecncky 50 Part 2 NRS eReports Report Interpretation Guidelines ccccccceceseeeseeseeet
34. and Report Interpretation Guidelines April 2015 4 3 Home Select the Home option from the CIHI Projects Dropdown Menu to access the NRS Launch Page at any time 4 4 Shared Reports Select the Shared Reports option from the CIHI Projects Dropdown Menu to access the Shared Reports folder Figure 4 3 which contains a link to the NRS eReports folder a User Defined NRS eReports folder and a link to the Launch Page Figure 4 3 The Shared Reports Folder Shared Reports 6 o aa a NRS eReports User Defined NRS eReports Owner Administrator Owner Administrator Modified 1 20 11 4 58 19 PM Modified 12 19 12 7 46 59 PM NRS Launch Page Owner Administrator Modified 4 30 12 8 49 00 AM Export PDF Gy e From the Shared Reports folder all of the NRS eReports are accessed via the NRS eReports folder Figure 4 4 This folder contains all three report options that are available in the NRS eReports system as well as two Peer Information Reports The NRS eReports folder is where you will go to create new reports To view a sitemap of the NRS eReports folder refer to Appendix A Figure 4 4 The NRS eReports Folder NRS eReports o o aa a 1 NRS Quick Indicators 2 NRS Comparative Reports Owner Administrator Owner Adminis or Modi Modifi ew S indic t the aci 7 tic al yi can sele eports car and reporting d as tables or graphs Peer Information Report for 3 NRS
35. are defined in the report query These constraints are otherwise known as the Report Filter and are written in a technical language that the average user may find challenging View Filter This window permits additional filters to be placed on the retrieved data In this way users can more narrowly specify what data is included or excluded from a particular report See Section 7 8 for more details about using the View Filter Prompt Details This window shows the selections that you made on the Prompt screen Page By Axis The Page By axis appears at the top of each report grid or graph and provides you with a way to change which information is displayed in the report Using this axis you can restrict visible grid or graph data according to a specific attribute or metric The Page By axis may automatically include metrics and attributes that are available in the report or you may have to add desired metrics and attributes using the Pivot Buttons see Section 7 5 for more details depending on which report you have created The metrics attributes in the Page By axis can also be moved from the Page By axis into the report rows or columns Report Grid or Graph In this window you can see in addition to the data returned for the report the number of rows and columns comprising it CIHI 2015 34 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Report Bar This bar is located in the to
36. are times when the title representing a data element is too long to be fully displayed in the legend of the PDF graph This issue can be resolved by selecting Show Advanced Options on the PDF Options page then checking the box for Use Bitmaps for Graphs option Now the graph legend will display the full titles belonging to each data element Exporting a Report to Other File Formats A report may be exported in a variety of formats by selecting the Export icon from the Home toolbar or from the Home drop down menu Once the selection has been made a new page containing Export options will appear Note that different options will be displayed on this page depending on whether you are currently viewing only a grid that is only the data table is being displayed or whether you are viewing a graph or grid and graph report Exporting a Grid Report By default the report will be exported in the format of an Excel With Plain Text file This type of format allows greater manipulation of the data once it is in Excel The Excel With Formatting option is more appropriate for presentation purposes Note that exporting using Excel With Plain Text will mean that only the selected metrics on the grid will appear in the exported report In both cases there is an Expand All Page By Fields option available Checking the Expand All Page By Fields box will produce an exported report that shows results for all available selected metrics Other available formats s
37. be influenced by complexity of the cases accepted by the facility and client characteristics as well as availability of staffing resources among other things Any difference between this indicator and the LOS indicator reflects days waiting for discharge from rehabilitation Available metrics average mean median standard deviation minimum maximum 25th percentile 75th percentile Active Rehab Length of Stay Efficiency Available in e NRS Comparative Reports gt Outcomes at Discharge gt 5 Length of Stay and Service Interruptions NRS Comparative Reports gt Resource Utilization gt 5 Functional Status Gain by RPG NRS Analytical Reports gt Outcomes at Discharge NRS Analytical Reports gt Outcomes at Follow up NRS Analytical Reports gt Resource Utilization The change in Total Function Score per day of client participation in the rehabilitation program Calculation is based on Total Function Score Change divided by Active Rehab LOS for each CIHI 2015 99 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 client averaged over the number of clients As with the Active Rehab LOS indicator service interruption days and days waiting for discharge are not included Inclusions exclusions Requires completion of elements 41 to 58 all FIM instrument items on both the admission and discharge assessments 21 Admission Date on the admission assessment 25A B Service Interruption Dates if ap
38. be resolved by selecting the Excel With Formatting option and checking the Export Graphs as Live Excel Charts box Now the graph legend will display the full titles belonging to each data element To export from graph or grid and graph view 1 View the report in graph or grid and graph view 2 Click the PDF or Export icon on the Home toolbar 3 Print or save the document in exported format OR 1 View the report in graph or grid and graph view 2 Open the Home drop down menu 3 Select Export 4 Define Export options 5 Click Export 6 Print or save the document in exported format CIHI 2015 49 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 To export from the History List 1 Navigate to the History List 2 Click the PDF or Export icon for a particular report 3 Print or save the document in exported format Tip Exported reports and graphs can be saved to a folder on your personal computer if desired Once saved outside of the NRS eReports system however the report becomes a static snapshot in time and the data does not get refreshed Only reports within the NRS eReports system may be updated with new data at a later point in time 8 3 How to Print a Report A report can be printed by selecting the Print icon from the Home toolbar or Home drop down menu Once the selection has been made a new page containing print options will appear You may customize the prin
39. by selecting a desired Facility type Each facility denotes itself as General or Specialty prior to beginning participation in the NRS Refer to Appendix B for definitions of General and Specialty facility types ii By Number of Beds A peer group may be chosen by selecting facilities that have a certain number of rehabilitation beds Users choosing this selection method are able to pick from a list of size groupings iii By Facility Name Facility Number A peer group may be chosen by selecting one or more facility names or numbers to add to the group Note Quick Indicator reports do not allow you to choose a peer group Instead facility type is the only peer group available and the selection of General or Specialty is based on the designation of the facility that is the focus of the report Only Comparative Reports and Analytical Reports provide users with the ability to choose their peer groups using the above mentioned criteria The Peer Information Reports available in the NRS eReports folder may assist users in deciding which other facilities best represent their peers CIHI 2015 18 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 All This column provides indicator values for all facilities participating in the NRS across Canada The NRS is a voluntary reporting system and therefore the data presented in the All column is not necessarily representative of all inpatient rehabil
40. choose to follow up only a specific client segment the results may not be representative of all clients discharged from that facility Available metrics count percent Clients Maintaining General Health Status Available in e NRS Comparative Reports gt Outcomes at Follow Up gt 3 Client Follow Up Count e NRS Analytical Reports gt Outcomes at Follow Up The number and percentage of follow up clients reporting the same or improved 70 General Health Status at the follow up assessment as compared to the discharge assessment An example of improved health status would be a report of Fair on discharge and Good at follow up Inclusions exclusions This indicator requires completion of element 70 on both the discharge and follow up assessments Records with a response code of 8 Unable to assess for either the discharge or follow up assessment are not included in the calculation of N Follow up records with element 70 8 Unable to assess are included in the denominator for percentage calculations Interpretation considerations This indicator may give some indication of the proportion of clients reporting maintained or improved health status on follow up For facilities that choose to follow up only a specific client segment the results may not be representative of all clients discharged from that facility Available metrics count percent Clients Reporting Improved Health Status Available in e NRS Comparative Reports gt Outco
41. client is admitted to the rehabilitation facility and the date on which the client is discharged from the rehabilitation facility Clients admitted and discharged on the same day have an LOS of 1 day Any days on which the client could not participate in the rehabilitation program due to a health reason are excluded from the calculation see Service Interruption Length of Stay Efficiency tThe change in Total Function Score see Total Function Score per day of client participation in the rehabilitation program Calculated as change in Total Function Score from admission to discharge divided by length of stay see Length of Stay Locomotion Domain FIM instrument Includes the FIM instrument motor items that assess locomotion Walk Wheelchair and Stairs CIHI 2015 140 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Locomotion Stairs FIM instrument Includes going up and down 12 to 14 stairs one flight indoors Locomotion Walk Wheelchair FIM instrument Includes walking once in a standing position or if using a wheelchair moving forward once in a seated position and on a level surface M Mean For the purposes of the NRS defined as the value obtained by adding all of the individual values for example FIM instrument scores days waiting for admission in a group and dividing that sum by the number of values in the group Describes the arithmetic mean of a set of value
42. data cut is taken two weeks after the data submission deadline This additional time between the submission deadline and the data cut allows facilities to submit corrections for records that were submitted by the submission deadline but were rejected due to errors 9 4 Data Submission Options Facilities have two options for submitting NRS records Option 1 Submit all records for the quarter in which they occur For example if a client is admitted in Q3 and is discharged in Q4 the admission assessment is completed and submitted in Q3 and the discharge assessment is completed and submitted in Q4 Facilities using this method may consequently have open records when an admission record is submitted in one quarter but the corresponding discharge record has not yet been submitted This option will also include complete admission and discharge records for clients who were admitted and discharged within the same quarter Implications for reporting Facilities that submit under Option 1 are able to generate reports that contain up to date to the latest reporting quarter admission data However any reports which provide data that requires complete records both admission and discharge data submitted for example Length of Stay and Service Interruptions will be generated using only the complete records that have been submitted Option 2 Submit admission and discharge records together in the quarter in which the discharge occurred
43. example number of clients length of stay Total Function Score A full listing and description of available metrics is provided in Chapter 14 Terms that relate to NRS metrics are described below Average Mean For the purposes of the NRS the terms average and mean are used interchangeably Averages means are calculated by adding the individual values for example FIM instrument scores days waiting for admission in a group and dividing that sum by the number of values in the group It is sometimes called the arithmetic mean of a set of values Example Five Total Function Scores 54 67 83 100 and 120 Average Mean Total Function Score 54 67 83 100 120 5 84 8 Median The median represents the middle value in a group when the values are arranged in an increasing order If there is an even number of values the median is the average of the middle two values Example Five Total Function Scores 54 67 83 100 and 120 The middle ranked value 83 is the median CIHI 2015 17 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Note that the median is not the same as the mean though these two values may on occasion be the same for a particular data set When the mean and median values are the same the distribution of the values is normal or symmetrical If the mean is higher than the median then the data is skewed to the right and there may be outliers in the up
44. for Discharge 1 Home without health services 02 Inpatient acute unit same facility 1 Goals met discharged to community 2 Home with paid health services 03 Inpatient acute unit different facility 2 Goals met transfer to other unit facility 3 Boarding house 04 Rehabilitation unit same facility 3 Goals not met 4 Assisted living 05 Rehabilitation unit different facility 4 Facility agency withdrew services 5 Residential care 06 Ambulatory care service 5 Client withdrew 6 Shelter 07 Private practice 6 Client no longer eligible funding CIHI 2015 74 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 15 Post Discharge Living Setting 7 Public place 32 Referred To 08 Drug dependency service 31 Reason for Discharge 7 Client moved 8 Other 09 Community services 8 Client deceased 9 Acute care 10 Residential care facility 50 Not available temporarily 11 Legal service 70 Asked unknown 12 Educational agency 13 Home care agency 97 Other 50 Not available temporarily 70 Asked unknown 90 Not applicable Codes from the three elements above have been grouped together to form the following categories for Discharge Destination Home without services Post Discharge Living Setting 1 Home with services Post Discharge Living Setti
45. function based on the elements tested Inclusions exclusions Cognitive Function Score is calculated from follow up records containing complete FIM instrument Total Function Scores that is both motor and cognitive components Records for which no FIM instrument assessment has been completed are excluded Interpretation considerations The Cognitive Function Score isolates the cognitive components of the FIM instrument and allows for a better comparison of cognitive function between FIM instrument assessments Available metrics average mean median standard deviation Cognitive Function Score Change Available in e NRS Comparative Reports gt Outcomes at Discharge gt 2 Functional Status at Admission and Discharge From Facility e NRS Analytical Reports gt Outcomes at Discharge Describes the average change in Cognitive Function Score from admission to discharge It is calculated as the difference between the Admission Cognitive Function Score and Discharge Cognitive Function Score for each client episode averaged for all episodes See Cognitive CIHI 2015 123 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Function Score in the Summary Functional Assessment Scores section for more details on the calculation of this indicator Inclusions exclusions Requires completion of all FIM instrument cognitive elements 54 to 58 on both the admission and discharge assessments Interp
46. instrument and CIHI assessments are mandatory on the admission assessment as are several other data elements If 19A 4 Un planned Discharge then the following mandatory elements are the minimum required for the record to be accepted as complete 4 Chart Number 5 Health Care Number 6 Province Territory Issuing Health Care Number 7 Sex 8 Birth Date 9 Estimated Birth Date if applicable 21 Admission Date 30 Discharge Date 34 Rehabilitation Client Group 80 Most Responsible Health Condition 81 Pre Admit Comorbid Health Conditions 83 Transfer or Death Health Condition if client transferred or died Note Data elements reported in addition to the minimum requirements will be included in the quarterly report indicators where applicable Note however that in many reports Un planned Discharges are excluded as they lack most admission and discharge data elements Discharge Records The definition of a complete discharge record will vary depending on the coding of data element 31 Reason for Discharge If 31 1 Service goals met and discharged to community or 2 Service goals met and referral transfer to other unit facility then FIM instrument and CIHI assessments are mandatory on the discharge assessment as are several other data elements If 31 3 Service goals not met then the following mandatory elements are the minimum required for the record to be accepted as complete 30 Discharge Date 32 Referred To 3
47. is felt to impact on the client s progress in rehabilitation This does not include weekend passes to visit family at home or temporary bed closures Short Stay One of the available options for coding Admission Class in the NRS Refers to an inpatient rehabilitation stay lasting between 4 and 10 days The client is admitted for a brief intervention for example prosthetic adjustment OR the rehabilitation stay lasts only between 4 and 10 days because of medical complications OR the client was discharged against medical advice Can be coded on Admission if the length of stay is expected to fall within 4 10 days or re coded on Discharge to reflect unexpected change in Admission status Social Cognitive Domain FIM instrument Includes the FIM instrument cognitive items that assess social and cognitive skills Social Interaction Problem Solving and Memory Social Interaction FIM instrument Includes skills related to participating and co operating with others in therapeutic and social situations It represents how one deals with one s own needs together with the needs of others Participation includes socializing with others or becoming involved in group activities Co operation includes working or collaborating with others and following cueing coaxing and or directions Specialty Rehabilitation Facility A facility that provides comprehensive inpatient rehabilitation services or specialized rehabilitation programs This is ofte
48. items that assess social and cognitive skills Social Interaction Problem Solving and Memory Available metrics average mean standard deviation minimum maximum Social Cognition Function Score Change Available in e NRS Analytical Reports gt Outcomes at Discharge The difference between the scores on discharge and admission for the FIM instrument cognitive items that assess social and cognitive skills Social Interaction Problem Solving and Memory Available metrics average mean standard deviation minimum maximum CIHI 2015 130 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 15 Additional Help With NRS eReports 15 1 Demonstrated Help Tutorials If you click on the Help link that appears at the top of every NRS eReports page you will have access to 30 demonstrated help tutorials Each tutorial is approximately one minute long and shows you how to perform some common task within MicroStrategy Please note that these demonstrated help tutorials are generic MicroStrategy tutorials so some of the information available may not be applicable to NRS eReports 15 2 MicroStrategy Help Menu The MicroStrategy application that contains the NRS eReports has a built in Help feature To access the Help menu click on the Help link at the top of any page This will take you to the Demonstrated Help Tutorials screen discussed above The MicroStrategy Help menu can be accessed by clicking on th
49. length of stay see Active Rehab Length of Stay Admission FIM instrument Assessment The baseline functional assessment that is done using the FIM instrument at the time of admission to the rehabilitation program The FIM instrument should be administered within 72 hours of admission ASIA impairment scale A scale that describes the degree of motor and sensory involvement at admission to rehabilitation for traumatic and non traumatic spinal cord injury Developed by the American Spinal Injury Association Attribute Attributes allow for the presentation of data by categories They are added to reports to allow data to be summarized at varying levels of detail The attributes that appear in a particular report depend on the purpose of the report Attributes are typically displayed in the rows or page by axis of NRS eReports and are also sometimes used as selection prompts for example RCG prompt That is some of the attributes that can be displayed in the report are also used to select which data is used in that report Average For the purposes of the NRS defined as the value obtained by adding all of the individual values for example FIM instrument scores days waiting for admission in a group and dividing that sum by the number of values in the group Describes the arithmetic mean of a set of values and is more commonly referred to as mean in the NRS eReports B Bathing FIM instrument Includes bathing washi
50. of CIHI 2015 113 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 multiple sclerosis and the Date of Onset was coded as June 2006 date of diagnosis rather than December 12 2010 date of onset of exacerbation then the submitted Onset Days value for that client will be extremely high and will skew the resulting average for this indicator Available metrics average mean median standard deviation minimum maximum Patient Days Available in e NRS Comparative Reports gt Resource Utilization gt RPG Patient Days reports e NRS Analytical Reports gt Resource Utilization gt RPG Patient Days reports Available metrics Count of clients Count of days Patient Days Clients COUNT The number of clients included in an RPG Patient Days Report Generally this is the number of clients receiving inpatient rehabilitation or occupying rehab beds at any time during the reporting period of interest Clients admitted prior to April 1 2008 that still have no discharge date recorded are excluded from the Patient Days Clients COUNT Patient Days COUNT The number of days clients were in the rehabilitation bed for a particular RPG during the reporting period e g fiscal quarter or year This indicator is different than length of stay which can only be calculated for complete i e discharged episodes Patient Days are calculated for all complete episodes as well as those incomplete episodes with
51. or regional designation and or the self assignment of the facility Fiscal Year Available in e All NRS eReports Fiscal year in which the client is admitted discharged or followed up depending on the report being generated Follow Up Living Arrangements Available in e NRS Comparative Reports gt Outcomes at Follow Up gt 1 Follow Up Living Arrangements e NRS Analytical Reports gt Outcomes at Follow Up Describes the distribution of various living arrangements on discharge based on the response choice for element 76 Follow Up Living Arrangements The response choices for this element are as follows clinicians should code all that apply Living with spouse partner Living with family includes extended Living with non family unpaid includes friends Living alone Living in facility includes all levels of care except acute Other 50 Not available temporarily 70 Asked unknown 2 3 4 Living with paid attendant 5 6 7 For reporting purposes the response choices have been grouped as follows Living with family friends unpaid code 1 or 2 or 3 excluding code 4 CIHI 2015 76 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Living with family friends paid attendant code 1 or 2 or 3 and 4 Living with paid attendant only code 4 only Living alone code 5 Living in facility nursing home code 6 Other code 7 Inclusions exclusions Response codes 50 Not av
52. or you may have to add desired metrics and attributes using the Pivot Buttons see Chapter 7 5 for more details depending on which report you have created The metrics attributes in the page by axis can also be moved from the page by axis into the report rows or columns Patient Days The number of days that a client is present in an inpatient rehabilitation bed or facility in a given time period Calculated for both open and closed episodes of care Post Admit Comorbid Health Condition ICD 10 CA Health conditions that arise after admission and during the rehabilitation stay that affect the client s health functional status and resource requirements during the rehabilitation program This includes post admit complications and or comorbid conditions that delay interrupt or compromise the effectiveness of the rehabilitation program or represent high medical risk disorders e g previous cardiac arrest pulmonary embolus ruptured aneurysm Includes conditions of short during that were resolved during the stay and conditions that persist at discharge Post Discharge Living Setting Physical environment the client will be living in following discharge from the rehabilitation program Pre Admit Comorbid Health Condition ICD 10 CA Existing health conditions present at the time of rehabilitation admission that affect the client s health functional status and resource requirements during the rehabilitation program This includes pre admit compl
53. recent six fiscal years Open Year Data The NRS is comprised completely of open year data meaning that revisions to previously submitted NRS data may be made at any time FIM Instrument The NRS data set contains clinical data on functional status based on the 18 item FIM instrument The FIM instrument is used to measure outcomes of functional independence at admission and discharge and optionally on follow up after discharge It is composed of 18 items 13 motor items and 5 cognitive items that are rated on a seven level scale representing gradations from independent 7 to dependent 1 function for an overall maximum score of 126 18 items x 7 The FIM instrument measures disability and looks at the caregiver burden associated with the level of disability The overall FIM instrument score can be broken down into motor and cognitive subscales to provide further detail on identifying areas of functional loss The 18 item FIM instrument is the property of the Uniform Data System for Medical Rehabilitation a division of UB Foundation Activities Inc Coding Classification Diagnostic information is available in the NRS for data years 2008 2009 and onwards This information is based on the ICD 10 CA and CCI classification systems It is important to note that within the NRS a pick list of approximately 2000 ICD 10 CA and 100 CCI codes are available for selection by NRS assessors The different diagnosis and procedure attr
54. see your location within NRS eReports by clicking on the title of the report at the top of the screen Upon clicking the title the Current Location or trail of breadcrumbs is expanded and displayed see Figure 4 5 This toolbar lists the directory path of the page that you are currently viewing Each of the folder names in this trail of breadcrumbs is a hyperlink that will take you to that folder upon clicking For instance if you wanted to navigate up a level within the folder hierarchy you could click on the appropriate folder name in the toolbar to take you there This toolbar also contains Back and Forward buttons that enable you to navigate to locations or reports you have been to previously and an Up button that will move you from your current folder to the next level up in the folder structure Figure 4 5 Expansion of the report title to Current Location Trail of Breadcrumbs Toolbar CIHI 2015 14 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 In this example the user is viewing the NRS Comparative Reports folder which is located inside the NRS eReports folder which is located inside the Shared Reports folder LL National Rehabilitation Reporting System NRS gt Shared Reports gt NRS eReports gt 2 NRS Comparative Reports gt a m am e FOLDERS x Y i Shared Reports 1 Admissions Profile 2 Outcomes at Disch Owner Administrator Owner Administrator Y E NRS eRep
55. several seconds or up to one minute depending on the report that you chose to generate CIHI 2015 28 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 6 Once the report has been created you will see the Report screen The Report screen with all of its menus and toolbars will allow you to modify how the data is displayed Chapter 7 provides more information about the how to modify your report using the tools provided on the Report screen For instance you might a Drill from fiscal year to fiscal quarter b Alter the Page By options at the top of the report to display only certain data ona particular page or c Choose to display the data in a grid table a graph or both grid and graph 7 Once the report contains the data that you are interested in and looks the way that you want you may choose to export save or print your newly created report For details about these options please refer to Chapter 8 6 4 Creating Analytical Reports To create an Analytical Report 1 From either the NRS eReports Launch Page Chapter 3 or the NRS eReports folder Section 6 1 click on NRS Analytical Reports Figure 6 9 NRS Analytical Reports can be accessed from the NRS eReports folder ad NRS eReports oo aml a 1 NRS Quick Indicators 2 NRS Comparative Reports Owner Administrator Owner Administrator Modified 7 14 09 7 16 30 AM Modified 12 15 10 2 17 20 PM View at a glance report
56. that can be generated for example Age at Admission Functional Status at Discharge Follow Up Living Setting You can select options for various factors including peer group Rehabilitation Client Group RCG and reporting period Reports can be viewed as tables or graphs or both Each of these four categories of Comparative Reports will be described in one of the following sections Prompt screen For all NRS Comparative Reports the user is presented with a single prompt page offering a number of choices that allow the user to customize the contents of the resulting report The prompt page contains a combination of the following choices e Facility allows you to select your facility name number e Fiscal Year s allows you to choose the year s included in the report e Rehabilitation Client Group allows you to select RCGs that you are interested in if no choice is made the data will reflect all RCGs e Peer Group allows three different ways to select a peer group for comparisons Peer Group Prompts There are three prompts to define peer groups by either facility type number of beds or by facility name The user is encouraged to choose a peer group through selecting options within only one of these three prompts Each of the three peer group prompts is detailed below Note Defining a Peer Group is optional to the user The Default for the Peer Group CIHI 2015 62 NRS eReports Manual User Guide and Report Interpretation Gui
57. the Facility Peer and National levels by quarter for the last 5 fiscal Unknown Referred to Facilty Unknown Health Card Number and Unknown Date Ready for 3 Click on the name of the report that you wish to generate 4 You will now be prompted for the Facility whose data you are interested in viewing The facilities are listed in alphabetical order and each contains its corresponding facility number You can scroll through the list or conduct a search for the facility name or number using the Search box Tip If you use the Search box ensure that the Match Case tick box is unchecked to provide you with maximum usability You are only permitted to select one Facility for these reports Once you have found the desired Facility either double click on it or highlight it and press the arrow button to move it to the Selected box on the right If you need to change your selection the lower arrow button 4 can be used to send your selection back to the Available box on the left Figure 6 4 Facility Prompts User to Create Quick Indicator Reports Select Your Facility Select the facility you would like included at the facility level in the report This prompt allows only one selection Search for Match case a Available Bluewater Health Norman Site ON 54417 Brant Community Healthcare System Brantford General Hospital ON 54678 Bridgepoint Hospital ON 51436 e Brockville General H
58. the report Enter a brief description of the report Decide whether you want to select new prompt values each time the report is rerun If so ensure the Keep Report Prompted box is checked If not uncheck the box Define the Advanced Options if applicable 9 Click OK NOoahWOND oo CIHI 2015 47 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 10 Click Return to Original Report to return to the Report screen or Run Newly Saved Report to return to the Prompt screen 8 2 Exporting Reports A report can be exported as a Microsoft Excel HTML CSV or text file by clicking the Export icon in the Home toolbar or from the Home drop down menu Likewise a report can be exported as a PDF file directly by clicking the PDF icon in the Home toolbar or by selecting Export from the Home drop down menu Exporting a Report to PDF Format A report may be viewed as a PDF document by selecting the PDF icon from the Home toolbar or by selecting Export from the Home drop down menu Once the selection has been made a new web page containing PDF options will appear You may customize the appearance of the PDF document by manipulating any of the available options or you may directly select Export at the bottom of the page The latter option will create a PDF document based on the software s default settings You can then save this document to your files to share with others Tip When graphing data there
59. wear in public Assessment starts in front of the closet or dresser drawers and includes reaching for items of clothing Drilling Drilling down refers to looking at more specific groupings of data For example if data is shown for a particular fiscal year you might drill down to view the data at the level of reporting periods i e quarters Drilling up refers to looking at less specific larger groupings of data For instance you might choose to collapse data across various age groups if age was not an important factor in your analysis In this case you are drilling up from the level of age groups Likewise if you were only interested in overall number of clients requiring rehabilitation for a particular impairment you might drill up from the level of sex i e collapse data across both sexes You could also drill up from the level of Rehabilitation Patient Group RPG to the higher Rehabilitation Group RG level E Eating FIM instrument Includes using suitable utensils to scoop and bring food to the mouth as well as chewing and swallowing once the meal is presented in the customary manner on a table or tray Includes all intake of nutrition over a 24 hour period including tube feeding Episode For the purposes of the NRS an episode consists of a complete Admission and a Discharge record and encompasses the entire stay in inpatient rehabilitation The analyses in the NRS reports are
60. 3A Referred to Province Territory 33B Referred to Facility Number if 32 is a facility 83 Transfer or Death Health Condition if client transferred or died If 31 4 Facility agency withdrew services 5 Client withdrew 6 Client no longer eligible 7 Client moved or 8 Client deceased then the following mandatory elements are the minimum required for the record to be accepted as complete 30 Discharge Date 83 Transfer or Death Health Condition if client transferred or died CIHI 2015 55 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Note Data elements reported in addition to the minimum requirements will be included in the quarterly report indicators where applicable CIHI 2015 56 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 10 In Depth NRS Quick Indicators At this point you should be familiar with some important NRS eReports terms Ensure that you understand these terms before proceeding You can find descriptions of these terms in Chapter 5 e Attributes e Metrics e RCG e Andmore For a complete list of all terms used in NRS eReports refer to Appendix B 10 1 Overview Quick Indicators are the quickest and simplest type of report to generate They are at a glance reports of several admission discharge and follow up indicators There are 10 Quick Indicator reports available 9 in graph format and 1 in grid format All
61. 4 to 58 inclusive that assess various components of cognitive function communication social interaction problem solving etc at the time of discharge The Cognitive Function Score ranges from 5 to 35 and provides a score that describes a client s cognitive function based on the elements tested Inclusions exclusions Cognitive Function Score is calculated from discharge records containing complete FIM instrument Total Function Scores that is both motor and cognitive components Records for which no FIM instrument assessment has been completed for example records with Admission Class 4 Un planned Discharge are excluded Interpretation considerations The Cognitive Function Score isolates the cognitive components of the FIM instrument and allows for a better comparison of cognitive function between FIM instrument assessments Available metrics average mean median standard deviation minimum maximum Cognitive Function Score at Follow Up Available in e NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up e NRS Analytical Reports gt Outcomes at Follow Up This is the sum of the five FIM instrument elements 54 to 58 inclusive that assess various components of cognitive function communication social interaction problem solving etc at the time of follow up assessment The Cognitive Function Score ranges from 5 to 35 and provides a score that describes a client s cognitive
62. 5 vi NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Note If you are viewing this manual electronically you may take advantage of hyperlinks that have been created to allow you to quickly jump from one location of the document to a related location For example some terms that are used may contain hyperlinks to their associated definitions in another part of the document Words that are hyperlinked to another location will be blue and a hand will appear when you position your cursor over them To return back to your former location after following a hyperlink simply click the bookmark located at the left of the screen The table of contents is also hyperlinked to allow you to quickly navigate to your desired chapter Symbols Used in This Manual y Notes 4 Caution Y Tip 2 Key Points Further New Q Resources O Web Links Gs Phone Email lt Feedback a M Stop F Important Note CIHI 2015 vii NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Part 1 NRS eReports User Guide Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Introduction to NRS eReports Accessing NRS eReports NRS eReports Launch Page NRS eReports Navigation Toolbar NRS eReports Terminology Creating Reports Modifying and Formatting Reports Saving Exporting and Printing CIHI 2015 NRS eReports Manual User Guide and Report Inter
63. 6 Marten ne hide mecha on ea Ga eee nese ek Wa GAG ae TAHA ee 10 4 4 Shared Reports orrein e E be let E ete ee tent t 10 4 5 My REPOS n eee e leak eaa aaae de a AA E chee eae oe eae 11 4 6 Hist ry Li t r e a a A E A RAE E EA KE EEA EEEE 11 4 7 Preferences ae ine eee Ae nego PT ET anger At EPEAT an PP PRIDE T BRL EPEC RC ATER eT 12 4 8 Soare h BOX sorrara e a u pestered Sree eu AE hae E a a 13 4 9 Helpar ee e hs e REEE E E A 14 4 lou OOO ecccteeant tu eucahten aaa ae a a ea aa a aaen 14 4 11 Current Location Trail of Breadcrumbs Toolbar cceseeeeeeeeeeeeeeeeneeeeeeeees 14 4 12 Acton Toolbars nenene an a e a a A A E Eai 15 5 NRS eReports Terminology cccccceeeeeeesecceceeeeeeeeeeseceaeeeeeeeeeeeeesenaaeeeeeeeeeteene 16 5 1 tolo a Reema ANERE ER E TESARI ASE AT EE EAT IE EE TEENE 16 5 2 POM DIS ryrie r AE E E E E 16 5 3 AttribUtE Sie a a E E 16 5 4 Rehabilitation Client Groups sssssseeeseesssseserrrntrrssrrrrrrrnrttsstrttnrnntrsserrnnnrnnnenserrnnen 17 5 5 Rehabilitation Patient Groups v 2ac duanicngaidngeddv we ded dodo idande gee neuen 17 5 6 MAGI ICS are tetas saab A eb etek es E EEA EEE REEE A yaad eee 17 5 7 Dc Lae DEEA E PEE E EE EEE E EEEE EEE or 19 5 8 Eae Aaa EE E a ed ees Meda ese ed ae ces dak eee 20 6 Creating Reports xc tei gaccesactecr teeta aytacuectecote acai tacueestaenes aueaceesnteld e E ERTES EEST 21 6 1 Types of Reports Available 2 i cscccss iccsetoitianede ekeavlersie
64. 8 to 126 This metric is the sum of the Total Function Scores for each discharge record included in the report divided by the number of discharge records Requires completion of all FIM instrument elements 41 to 58 on the discharge assessment Inclusions exclusions The Total Function Score is calculated from records containing complete FIM instrument codes for data elements 41 to 58 inclusive Records for which no FIM instrument assessment has been completed for example records with Admission Class 4 Un planned Discharge are excluded Interpretation considerations The Average Discharge Function Score can be compared at the facility peer and national levels or to the average Admission Function Score for that facility The score should be considered along with indicator distributions such as Rehabilitation Client Group Reason for Discharge Discharge Living Setting and Arrangement to give a clearer picture of the typical discharge situation for a rehabilitation client Refer to the NRS Rehabilitation Minimum Data Set Manual for more detailed information on coding the various FIM instrument elements A more complete picture of client function can be obtained by breaking down the Total Function Score into its motor and cognitive components see below Available metrics average mean median standard deviation minimum maximum Total Function Score at Follow Up Available in e NRS Quick Indicators gt 9 Average Follow Up Tot
65. D OF RU AP OD OF RU Median AP OD OF AP OD OF Standard Deviation AP OD OF AP OD OF Minimum AP OD Maximum AP OD Total Function Score at Discharge Average Mean QI 3 OD OF RU OD OF RU Median OD OF OD OF Standard Deviation OD OF OD OF Minimum OD Maximum OD Total Function Score at Follow Up Average Mean QI 9 OF OF Median OF OF Standard Deviation OF OF Total Function Score Change Average Mean QI 4 OD RU OD RU Median OD RU Standard Deviation OD OD Minimum OD Maximum OD Percent OD OD Percent Standard Deviation OD OD Motor Function Score at Admission Average Mean AP OD OF AP OD OF Median AP OD OF AP OD OF Standard Deviation AP OD OF AP OD OF Minimum AP OD Maximum AP OD CIHI 2015 93 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Table 14 2 Availability of Function Score and CIHI Cognitive Score metrics across NRS eReports Report sub types are abbreviated as follows AP Admissions Profile OD Outcomes at Discharge OF Outcomes at Follow Up RU Resource Utilization cont d NRS Comparative NRS Analytical Reports Reports Motor Function Score at Discharge Average Mean OD OF OD OF Median OD OF OD OF Standard Deviation OD OF OD OF Minimum OD Maximum OD Motor Function Score at Follow Up Average Mean OF OF Median OF OF
66. Discharge Outcomes at Follow Up and Resource Utilization 3 NRS Analytical Reports Owner Adm Modified 7 functi tatus a n U attributes and metrics that will b in the reports 3 Outcomes at Follow up Owner Adm Modified 7 14 Build your own rej e attributes and up U attributes and metrics that will b 3 Each Analytical Report folder contains at least two different reports one that permits peer and national comparisons in the same manner as Comparative Reports these reports contain Peer Comparisons in their names and one that does not prompt you to select a peer group but does permit selecting more than one facility in the Facility prompt these reports contain Multiple Facilities in their names Creating the latter of these reports allows you to view data from multiple facilities without having their data aggregated into one peer group This may be of particular use for regional health authorities or facilities that are subdivided and have more than one facility number 4 Regardless of which Analytical Report you have chosen to generate you will be prompted to select values through which to filter the data There are five standard prompts for each CIHI 2015 30 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Analytical Report the Peer Comparisons reports contain additional prompts for determining a peer group a Facility allows
67. For more information about drilling refer to Chapter 7 CIHI 2015 19 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 5 8 Filtering A filter sifts the data in your data source and presents you with the specific information you request When you analyze a report it is important to understand the filter conditions that are being applied to the report This allows you to better understand what data is being excluded from the results You can see filter definitions and apply your own filter in several ways Look at the definition of a report s filter To see the filtering conditions the report designer applied to the report select Report Details from the Tools menu refer to Chapter 7 Create a View filter You can apply a filter to the current instance or view of a report using a View filter The View filter limits the data being displayed on a report without re executing the report against the data source refer to Chapter 7 Display or hide rows and columns You can narrow your view of a report to only the rows and columns you want to see This is achieved using the Filter on Selections feature refer to Chapter 7 CIHI 2015 20 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 6 Creating Reports 6 1 Types of Reports Available There are three main types of reports that can be created within the NRS eReports environment All can be accessed from the N
68. M instrument The sum of the scores for the five cognitive elements on the FIM instrument A higher Cognitive Function Score suggests a higher level of independent functioning in cognitive activities See Cognitive Subscale below Can be calculated on admission and on discharge Cognitive Subscale FIM instrument The five items of the FIM instrument related to cognitive function Comprehension Expression Social Interaction Problem Solving and Memory Communication Domain FIM instrument Includes the FIM instrument cognitive items that assess communication skills Comprehension Expression Comprehension FIM instrument Includes understanding of either auditory and or visual communication for example writing sign language gestures Communication can involve simple and or complex messages with the scores reflected accordingly Continuing Rehabilitation One of the available options for coding Admission Class in the NRS This is part of a rehabilitation inpatient stay that began in another rehabilitation unit or facility The client was admitted directly from a rehabilitation program in another unit or facility with the same RCG see Rehabilitation Client Group Includes transfers to a rehabilitation unit within the same facility Current Methodology Case Mix Case Mix metrics may be found in Current Methodology or Original Methodology Comparative Reports or may be named as such in the Analytical
69. Median OD OF OD OF Standard Deviation OD OF OD OF Minimum OD Maximum OD CIHI Cognitive Score at Follow Up Average Mean OF OF Median OF OF Standard Deviation OF OF CIHI Cognitive Score Change Average Mean OD OD Median OD Standard Deviation OD OD Minimum OD Maximum OD Percent OD OD Percent Standard Deviation OD OD CIHI 2015 95 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Table 14 2 Availability of Function Score and CIHI Cognitive Score metrics across NRS eReports Report sub types are abbreviated as follows AP Admissions Profile OD Outcomes at Discharge OF Outcomes at Follow Up RU Resource Utilization cont d NRS Quick NRS Comparative NRS Analytical Indicators Reports Reports Self Care Function Score at Admission Average Mean AP OD Standard Deviation AP OD Minimum AP OD Maximum AP OD Self Care Function Score at Discharge Average Mean OD Standard Deviation OD Minimum OD Maximum OD Self Care Function Score Change Average Mean OD Standard Deviation OD Minimum OD Maximum OD Sphincter Function Score at Admission Average Mean AP OD Standard Deviation AP OD Minimum AP OD Maximum AP OD Sphincter Function Score at Discharge Average Mean OD Standard Deviation OD Minimum OD Maximum OD Sphincter Function Score Change
70. NRS Each facility coordinator is responsible for ensuring that only staff who need access to the reports are registered as users The terms and conditions of use of data in the NRS eReports are governed by a service agreement signed by participating organizations If your organization is already submitting data to the NRS a new service agreement will be signed before CIHI provides access to eReports If organizations are preparing to submit their first data to CIHI a NRS service agreement must be established If you have any questions please contact the NRS team at nrs cihi ca CIHI 2015 2 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 1 3 Data Available The data mart referenced by NRS eReports contains data from the National Rehabilitation Reporting System since its inception However only the most recent six fiscal years will be made available to report users NRS eReports are currently updated on a quarterly basis usually within three weeks following the data submission deadline for the quarter Note that if a facility does not submit its data on time its data will not be included in any of that quarter s eReports and will only be added after the subsequent fiscal quarter Until that time the facility s older data will remain available For more information about submitting data submission options and submission deadlines please see Chapter 9 CIHI 2015 3 NRS eReports Manual
71. NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Canadian Institute for Health Information Institut canadien i d information sur la sant All rights reserved No part of this publication may be reproduced or transmitted in any form or by any means electronic or mechanical including photocopying and recording or by any information storage and retrieval system now known or to be invented without the prior permission in writing from the owner of the copyright except by a reviewer who wishes to quote brief passages in connection with a review written for inclusion in a magazine newspaper or broadcast Requests for permission should be addressed to Canadian Institute for Health Information 495 Richmond Road Suite 600 Ottawa Ontario K2A 4H6 Phone 613 241 7860 Fax 613 241 8120 www cihi ca 2015 Canadian Institute for Health Information Function Scores referenced in this document are based on data collected using the FIM instrument The 18 item FIM instrument and impairment codes referenced herein are the property of Uniform Data System for Medical Rehabilitation a division of UB Foundation Activities Inc Rehabilitation Client Groups adapted with permission from the UDSMR impairment codes 1997 Uniform Data System for Medical Rehabilitation a division of UB Foundation Activities Inc all rights reserved NRS eReports Manual User Guide and Report Interpretat
72. PG is associated with a typical cost weight which is intended to be updated annually See also Chapter 13 for more information Report A report is the outcome of analytical queries The knowledge gained from reports can be used in decision support activities A report is created by querying a CIHI datamart containing Canadian health data such as the National Rehabilitation Reporting System Reports can be formatted in three ways 1 Grid report data is displayed in a table 2 Graph report data is displayed on a graph 3 Combined Grid Graph report data is displayed in both a data table and on a graph You can switch between these three formats by using the View Menu or the appropriate toolbar buttons The formatting options that are available to you in each of these formats are different and the visible toolbars and menu items will automatically update as you switch between them S Self Care Domain FIM instrument Includes the FIM instrument motor items that assess basic activities necessary for daily personal care Eating Grooming Bathing Dressing Upper Body Dressing Lower Body and Toileting Service Interruption Occurs when a client is unable to participate in the rehabilitation program due to a health condition that may or may not result in a transfer out of the rehabilitation bed or unit Service Interruptions are generally coded only when the client misses more than one day of active rehabilitation and the condition
73. RPG Case Mix Reports is calculated as the sum total number of weighted cases divided by the sum total number of complete episodes for the reporting period for the facility Case Mix Length of Stay COUNT The sum of the lengths of stay number of days from element 21 Admission Date to element 30 Discharge Date for each completed admission and discharge record pair for the clients included in the RPG Case Mix Reports Instances in which an admission and discharge occur on the same day are assigned a length of stay value of 1 day Inclusions exclusions Case Mix Length of Stay is different from all other lengths of stay reported in NRS eReports in that it includes Service Interruption Days in addition to including Days Waiting for Discharge Requires completion of element 21 Admission Date on the admission assessment and 25A B Service Interruption Dates if applicable and 30 Discharge Date on the discharge assessment In some of the RPG Case Mix Reports Un planned Discharges are excluded as the discharge record is not completed for these clients Interpretation considerations Case Mix Length of Stay can be influenced by many factors such as complexity of the cases accepted by the facility number of days waiting for discharge CIHI 2015 101 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 due to delays in the discharge process number of days accrued during service interruptions etc Care should be
74. RS eReports folder which is found in the Shared Reports folder Each type is described briefly below and in greater detail in chapters 10 to 12 Figure 6 1 The NRS eReports Folder NRS eReports Peer Information Report for 3 NRS Analytical Reports Facilities Submitting Follow up Data i Owner Modified 5 3 9 m dmission Profile Follow up and Peer RCG Information Report Owner Admini This folder contains the three main types of reports that can be created NRS Quick Indicators NRS Comparative Reports and NRS Analytical Reports It also includes two Peer Information Reports that have been created to assist facilities in the picking of peers NRS Quick Indicators Quick Indicators are the quickest and simplest type of reports to generate They are at a glance reports of several admission discharge and follow up indicators There are 10 Quick Indicator reports available 9 in graph form and 1 in table form All nine graphs have identical properties each reporting on a different indicator The 10th report displays a table containing four data quality indicators Reports present information based on facility facility type general or specialty and desired fiscal year s Indicators are presented at the Facility Peer and National All levels You will be prompted only for your facility name and number in order to generate the report CIHI 2015 21 NRS eReports Manual User Guide and Report Interpret
75. S eReports Report sub types are abbreviated as follows AP Admissions Profile OD Outcomes at Discharge OF Outcomes at Follow Up RU Resource Utilization cont d NRS Quick NRS Comparative NRS Analytical Indicators Reports Reports Communication Function Score at Admission Average Mean AP OD Standard Deviation AP OD Minimum AP OD Maximum AP OD Communication Function Score at Discharge Average Mean OD Standard Deviation OD Minimum OD Maximum OD Communication Function Score Change Average Mean OD Standard Deviation OD Minimum OD Maximum OD Social Cognition Function Score at Admission Average Mean AP OD Standard Deviation AP OD Minimum AP OD Maximum AP OD Social Cognition Function Score at Discharge Average Mean OD Standard Deviation OD Minimum OD Maximum OD Social Cognition Function Score Change Average Mean OD Standard Deviation OD Minimum OD Maximum OD CIHI 2015 98 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 14 2 NRS Metric Definitions in Alphabetical Order Active Rehab Length of Stay Available in e NRS Comparative Reports gt Outcomes at Discharge gt 5 Length of Stay and Service Interruptions NRS Comparative Reports gt Resource Utilization gt 5 Functional Status Gain by RPG NRS Analytical Reports gt
76. Stroke 98 77 6 100 5 201972014 Renao pacility 123 Brain Dysfunction 15 78 3 97 3 12 2 Attributes and Metrics Available in NRS Analytical Reports The attributes that are available in the different NRS Analytical Reports are listed in Table 13 1 in Chapter 13 For attribute definitions inclusion exclusion criteria and interpretation considerations refer to Section 13 2 The metrics that are available in the different NRS Analytical Reports are listed in tables 14 1 and 14 2 in Section 14 1 For metric definitions inclusion exclusion criteria and interpretation considerations refer to Section 14 2 CIHI 2015 70 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 13 In Depth NRS Attributes 13 1 Overview Attributes allow for the presentation of data by categories They are added to reports to allow data to be summarized at varying levels of detail For example the attribute sex might be added to a report to allow data from male and female clients to be shown separately The attributes that appear in a particular report depend on the purpose of the report A report designed to show client data as it relates to age for instance will necessarily include an age related attribute such as admission age group In the NRS Quick Indicators and NRS Comparative Reports the attributes that are present in each report are pre chosen by CIHI In NRS Analytical Reports however ea
77. ail For example the attribute sex might be added to a report to allow data from male and female clients to be shown separately The attributes that appear in a particular report depend on the purpose of the report A report designed to show client data as it relates to age for instance will necessarily include an age related attribute such as admission age group In the NRS Quick Indicators and NRS Comparative Reports the attributes that are present in each report are pre chosen by CIHI In NRS Analytical Reports however each user has the freedom to decide which attributes are included in each report Attributes are typically displayed in the rows or page by axis of NRS eReports and are also sometimes used as selection prompts for example RCG prompt That is some of the attributes that can be displayed in the report are also used to select which data is used in that report For example a user could use the bed grouping attribute to choose to include only data from small facilities in the report CIHI 2015 16 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Available attributes vary depending on report type Table 13 1 indicates the attributes that are available in the various NRS eReports Definitions descriptions and interpretation considerations for each attribute are listed in Section 13 2 5 4 Rehabilitation Client Groups Within the NRS a client is categorized into 1 of
78. ailable and 70 Unknown are included in the denominator for percentage calculations It is possible for a client to be coded with more than one living arrangement for example living with spouse and family but each client is counted only once in the calculation of N and percentages Follow Up Living Setting Available in e NRS Comparative Reports gt Outcomes at Follow Up gt 2 Follow Up Living Setting e NRS Analytical Reports gt Outcomes at Follow Up Describes the distribution of various living environments on follow up based on the response choice for element 77 Follow Up Living Setting The response choices for this data element are clinicians should code one option only 1 Home private house or apartment without health services 2 Home private house or apartment with paid health services for example home care support formal or informal private or publicly funded Boarding house includes rented room Assisted living includes group home retirement home supervised living setting Residential care long term care facility convalescent care nursing home Public place includes residing in the street parks and other public spaces Other 50 Not available temporarily 70 Asked unknown 3 4 5 6 Shelter includes night shelter refuges hostels for homeless 7 8 For reporting purposes the response choices have been grouped as follows Home private without services code 1 Home private with services
79. al Function Score Across RCGs e NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up CIHI 2015 118 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 e NRS Analytical Reports gt Outcomes at Follow Up Total Function Score is the sum of the scores from the 18 FIM instrument elements 41 to 58 inclusive in the data set Each element has a minimum score of 1 and a maximum score of 7 resulting in a value range of 18 to 126 This metric is the sum of the Total Function Scores for all follow up records submitted Inclusions exclusions The Total Function Score is calculated from records containing complete FIM instrument codes for data elements 41 to 58 inclusive Records for which no FIM instrument assessment has been completed for example records with Admission Class 4 Un planned Discharge are excluded Requires completion of data elements 41 to 58 on the follow up assessment Interpretation considerations Total Function Score at Follow Up can be compared to Total Function Score at Discharge as an aggregate outcome measurement Refer to the NRS Rehabilitation Minimum Data Set Manual for more detailed information on coding the various FIM instrument elements A more complete picture of client function can be obtained by breaking down the Total Function Score into its motor and cognitive components see below Available metrics average mean median st
80. ample of the NRS eReports Launch Page NRS Launch Page Tools Data a B g Ral 100 a Related Reports National Rehabilitation Reporting System Launch Page ify HRS Launch Pass Participating Facilities O Number of Admissions Average Days Waiting for Admission Number of Facilities ii e boca oe Oe eoe 2009 2010 2010 2011 2011 2012 2012 2013 2013 2014 2014 2015 Average Length of Stay Efficiency S 0 2009 2010 2010 2011 2011 2012 2012 2013 2013 2014 2014 2015 2009 2010 2010 2011 2011 2012 2012 2013 2013 2014 2014 2015 Overview Shared Reports Supporting Links The NRS was developed to support data collection by hospitals for inpatient rehabilitation dients who are mainly age 18 and older The rehabilitation services are E NRS Quick Indicators Updates provided in specialized rehabilitation hospitals and in rehabilitation units or fa designated rehabilitation beds of general hospitals Data are submitted at the time of NRS Comparative Reports Support admission discharge as well as optionally at follow up by more than 100 hospitals in n nine provinces and cover a range of health conditions One way NRS provides data E NRS Analytical Reports FAQs back to data providers is through a series of indicators induded in these eReports Education Data are updated every quarter within 3 weeks of the final NRS Error Correction a Deadline Last Fisca
81. an be used to aid users in the selection of appropriate peers Export PDF 2 The Analytical Reports folder Figure 6 10 displays the four types of reports that may be created a Admissions Profile CIHI 2015 29 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Build your own report to analyze admission indicators including client characteristics age sex and functional status at admission b Outcomes at Discharge Build your own report to analyze discharge indicators including client characteristics age sex outcomes at discharge referral source and functional status at discharge Wait times length of stay and service interruption data is also available for analysis c Outcomes at Follow Up Build your own report to analyze follow up indicators including client characteristics age sex and functional status at follow up Other indicators such as length of stay and service interruptions are also available for analysis d Resource Utilization Build your own report to analyze resource utilization and case mix indicators by Rehabilitation Group RG and Rehabilitation Patient Group RPG For a list of the attributes and metrics that may be used to generate each Analytical Report consult chapters 13 and 14 respectively Click on the category of Analytical Report that you would like to generate Figure 6 10 Four types of Analytical Reports may be created Admissions Profile Outcomes at
82. and 14 2 in Section 14 1 For metric definitions inclusion exclusion criteria and interpretation considerations refer to Section 14 2 11 3 Admissions Profile Comparative Reports The following section describes the contents of the Admissions Profile sub folder This folder contains seven reports These reports include summary data for clients admitted during the chosen reporting period and allow for peer and national comparisons For more information about the attributes and metrics contained in these reports refer to chapters 13 and 14 respectively 1 Admission by Referral Source View admission counts and percentages for a defined reporting period by the referral source 2 Admission by Rehabilitation Client Group View admission counts and percentages for a defined reporting period by RCG 3 Admission by Admission Class View admission counts and percentages for a defined reporting period by admission class 4 Admission by Pre Hospital Living Arrangements View admission counts and percentages for a defined reporting period by pre hospital living arrangements 5 Admission by Pre Hospital Living Setting View admission counts and percentages for a defined reporting period by pre hospital living setting CIHI 2015 64 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 6 Age at Admission to Facility View admission counts and percentages for a defined reporting period by age at the time of admis
83. and national levels 10 Data Quality Indicators Report Three data quality indicators are provided in this grid formatted that is table Quick Indicator report Columns indicating facility peer and national values are provided The indicators are expressed as both the number of records used in the calculation N and as percentages The three indicators included in this report are a subset of the indicators in the NRS Data Quality Report for Provinces Territories which is completed on an annual basis and sent to the deputy ministers of health of each province and territory in an effort to raise awareness and highlight data quality issues If the report does not show data for one or more of these indicators it is because your facility does not have any data to show e Unknown Date Ready for Admission e Unknown Health Care Number e Unknown Referred to Facility Number CIHI 2015 58 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Figure 10 1 Example of a Graph Formatted Quick Indicator Report PAGE BY Facility Rehab Centre 100 v Facility Type Specialty v Fiscal Year 2008 09 vie Rolling 6 fiscal years 1 value 1 value Average Length of Stay LOS across Rehabilitation Client Groups RCG m SS a n _ _ a SS Stroke Brain Dysfunction Neurological Conditions Spinal Cord Dysfunction B Facility Amputation Arhritis RCG Pa
84. andard deviation Total Function Score Change Available in e NRS Quick Indicators gt 4 Average Change in Total Function Score Across RCGs e NRS Comparative Reports gt Outcomes at Discharge gt 2 Functional Status at Admission and Discharge From Facility e NRS Analytical Reports gt Outcomes at Discharge e NRS Analytical Reports gt Resource Utilization gt RPG Case Mix and Functional Status Describes the average change in Total Function Score from admission to discharge This is the difference between the Admission Function Score and Discharge Function Score for each client episode averaged for all episodes See Total Function Score in the Summary Functional Assessment Scores section for more details on this indicator Inclusions exclusions Requires completion of all FIM instrument elements 41 to 58 on both the admission and discharge assessments Interpretation considerations Change in function indicators are expressed as averages A positive value indicates a score increase and a negative value indicates a score decrease Available metrics average mean median standard deviation minimum maximum percent percent standard deviation Total Function Score Change Percent This indicator describes the relative change in Total Function Score from admission to discharge This is calculated for each record as the difference between Total Function Scores on admission and discharge divided by the score on admission
85. arge gt 2 Functional Status at Admission and Discharge From Facility e NRS Analytical Reports gt Outcomes at Discharge Describes the average change in Motor Function Score from admission to discharge This is the difference between the Admission Motor Function Score and Discharge Motor Function Score for each client episode averaged for all episodes See Motor Function Score in the Summary Functional Assessment Scores section for more details on this indicator Inclusions exclusions Requires completion of all FIM instrument motor elements 41 to 53 on both the admission and discharge assessments Interpretation considerations Change in function indicators are expressed as averages A positive value indicates a score increase and a negative value indicates a score decrease Available metrics average mean median standard deviation minimum maximum Cognitive Function Score at Admission Available in e NRS Comparative Reports gt Admissions Profile gt 7 Functional Status at Admission to Facility e NRS Comparative Reports gt Outcomes at Discharge gt 2 Functional Status at Admission and Discharge From Facility NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up NRS Analytical Reports gt Admissions Profile NRS Analytical Reports gt Outcomes at Discharge NRS Analytical Reports gt Outcomes at Follow Up This is the sum of the five FIM instrument elements 54 to
86. as shown 100 improvement in function The Percent Change indicator is intended to show average relative change in FIM instrument scores only and should not be used as a measure of average improvement in client function Motor Function Score at Admission Available in e NRS Comparative Reports gt Admissions Profile gt 7 Functional Status at Admission to Facility e NRS Comparative Reports gt Outcomes at Discharge gt 2 Functional Status at Admission and Discharge From Facility NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up NRS Analytical Reports gt Admissions Profile NRS Analytical Reports gt Outcomes at Discharge NRS Analytical Reports gt Outcomes at Follow Up This is the sum of the 13 FIM instrument elements 41 to 53 inclusive that assess various components of motor function self care sphincter control transfers etc at the time of admission The Motor Function Score ranges from 13 to 91 and provides a score that describes a client s motor function based on the elements tested Inclusions exclusions Motor Function Score is calculated from admission records containing complete FIM instrument Total Function Scores that is both motor and cognitive components Records for which no FIM instrument assessment has been completed for example records with Admission Class 4 Un planned Discharge are excluded CIHI 2015 120 NRS eReports Manual User Guide an
87. ason the total column percentage may be less than 100 The difference between the reported total percentage and 100 may represent the percentage of records that are Unknown or Not applicable for a given indicator 9 5 Definition of a Complete Record The NRS only accepts complete and error free records into the database A complete record has all of the mandatory data elements coded and has passed through all edit checks when processed at CIHI Edit specifications at the data collection level and at the data processing level detect missing or incorrect data elements Records that have been rejected as a result of missing mandatory data elements or errors are not considered complete and are not accepted into the database Facilities can check the status of their submission files in the submission reports on the secure Operational Reports page of the CIHI website Facilities must correct any errors and resubmit these records for inclusion in the database Admission Records The definition of a complete admission record will vary depending on the coding of data element 19A Admission Class Refer to the NRS Rehabilitation Minimum Data Set Manual sections 3 and 4 for more details regarding the coding of this data element CIHI 2015 54 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 If 19A 1 Initial rehabilitation 2 Short stay 3 Readmission or 5 Continuing rehabilitation then complete FIM
88. ation Guidelines April 2015 NRS Comparative Reports Comparative Reports allow a bit more flexibility than Quick Indicator reports but require slightly more time and effort to build at least initially They provide a comprehensive set of NRS indicators at the Facility Peer and National All levels for the previous six fiscal years There are four categories of Comparative Reports i Admission Profile reports ii Outcomes at Discharge reports iii Outcomes at Follow Up reports and iv Resource Utilization reports Each category includes up to seven different types of reports that can be generated for example Age at Admission Functional Status at Discharge and Follow up Living Setting You can select options for various factors including peer group Rehabilitation Client Group RCG and the reporting period In most cases reports can be viewed as tables or graphs NRS Analytical Reports Analytical Reports are build your own reports that allow even greater flexibility but require a bit more time and effort to produce than the other two types of reports As with Comparative Reports you may select one of four categories However unlike Comparative Reports Analytical Reports allow you to display data based on any available attributes and metrics How to Decide Which Type of Report You Want The type of report that you choose to create will depend on a number of factors including for instance the attributes and metr
89. ation Guidelines April 2015 Table 14 1 Availability of metrics across NRS eReports Report sub types are abbreviated as follows AP Admissions Profile OD Outcomes at Discharge OF Outcomes at Follow Up RU Resource Utilization Report numbers are shown for Quick Indicators and Comparative Reports cont d NRS Quick NRS Comparative NRS Analytical Indicators Reports Reports Days Waiting for Admission Count AP OD Average Mean QI 1 OD5 AP OD OF Median OD5 AP OD 25th Percentile AP OD 75th Percentile AP OD Days Waiting for Discharge Count OD Average Mean QI5 OD5 OD OF Median OD5 OD 25th Percentile OD 75th Percentile OD Length of Stay Average Mean QI6 OD 5 RU 5 OD OF RU Median OD Standard Deviation OD Minimum OD Maximum OD 25th Percentile OD 75th Percentile OD Count OD RU Length of Stay Efficiency Average Mean QI7 OD 5 RU 5 OD OF RU Median OD Standard Deviation OD Minimum OD Maximum OD Onset Days Average Mean OD5 AP OD OF Median OD5 AP OD OF Standard Deviation AP OD OF Minimum AP OD OF Maximum AP OD OF CIHI 2015 91 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Table 14 1 Availability of metrics across NRS eReports Report sub types are abbreviated as follows AP Admissions Profile OD Outcomes at Discharge OF
90. atus data element is based on the client s perception of his or her overall health status rather than a measured observation and therefore has a qualitative nature Available metrics count percent Clients Reporting Improvement in Pain Available in e NRS Comparative Reports gt Outcomes at Discharge gt 3 Clinical Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Discharge The number and percentage of clients reporting pain on admission that reported either less pain or no pain on the discharge assessment based on the results coded for elements 59A C Impact of Pain These elements were derived from the 1996 National Population Health Survey developed by Statistics Canada This is one of the outcome indicators in the NRS and is based on client reporting The indicator is calculated based on the Pain Score the sum of the scores from data elements 59B Intensity of Pain Discomfort and 59C Activity Limitation Due to Pain Discomfort The score ranges from 4 to 9 where 4 is severe pain with most activities restricted and 9 is mild pain with no activity restrictions This indicator is calculated using all records for which Presence of Pain 59A yes on admission and where the difference between Pain Score on admission and Pain Score on discharge is positive i e smaller number on admission than on discharge Inclusions exclusions Records are excluded where 59A Client Unable to Answer on the admission and or discha
91. be generated Figure 6 3 shows the Quick Indicator reports that are available to you For a more detailed description regarding interpretation of each Quality Indicator report consult Chapter 10 CIHI 2015 23 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Figure 6 3 Example of the Quick Indicators Folder Containing 10 Quick Indicator Reports 01 Average Days Waiting for Admission Across Rehabilitation Client Groups RCGs Modified View Ave dmission for each Rehabilitation Client Group at the Facility Peer and National levels ove years Peer groups are based upon General Specialty facility types Export PDF 03 Average Discharge Total Function Score Across Rehabilitation Client Groups RCGs ha 27 42 AM W Averag tal Function Score for each Rehabilitation Client Group at the Facility Peer and Nab Sora level over ie last 5 fiscal years Peer groups are based upon General Speciatty facility types Export PDF 05 Average Days Waiting for Discharge Across Rehabilitation Client Groups RCGs Owner Administrator M 3 r each Rehabilitation Client Group eer groups are based upon Gen city Peer and ity facility types s Waiting g ver the Bst 5 Fecal years Export PDF 07 Average Length of Stay LOS Efficiency Across Rehabilitation Client ene RCGs 10 27 42 AM ath of Stay LOS Efficiency for each Rehabilitation Client Group at the Facility Peer a
92. cation skills Comprehension Expression Available metrics average mean standard deviation minimum maximum Communication Function Score at Discharge Available in e NRS Analytical Reports gt Outcomes at Discharge The sum of the scores on discharge for the FIM instrument cognitive items that assess communication skills Comprehension Expression Available metrics average mean standard deviation minimum maximum Communication Function Score Change Available in e NRS Analytical Reports gt Outcomes at Discharge The difference between the scores on discharge and admission for the FIM instrument cognitive items that assess communication skills Comprehension Expression Available metrics average mean standard deviation minimum maximum Social Cognition Function Score at Admission Available in e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge CIHI 2015 129 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 The sum of the scores on admission for the FIM instrument cognitive items that assess social and cognitive skills Social Interaction Problem Solving and Memory Available metrics average mean standard deviation minimum maximum Social Cognition Function Score at Discharge Available in e NRS Analytical Reports gt Outcomes at Discharge The sum of the scores on discharge for the FIM instrument cognitive
93. cess seek twee dexvcteicl betes kane teal iaeot eared loecels 69 12 1 COVGIVICW 22 EE E E eee Mui ated E EEEE TE 69 12 2 Attributes and Metrics Available in NRS Analytical Reports ssssnnneeeeeseeeeeeenenesee 70 13 In Depth NRS Attributes 2 25 ede Mail iced can ev sdgebes tc ceaan ddendee cecanduenacennesceecers 71 13 1 OVENI EW earte e venta cesacueth sone eea EEEE EEE EE E EES ERS 71 13 2 NRS Attribute Definitions in Alphabetical Order sssssssesssenssnrrnenssssrrrrrrnnnessee 72 14 In Depth NRS MGiics tata ett tccdeton dana a etter aaianied 87 14 1 OIRA E R E E A A A A 87 14 2 NRS Metric Definitions in Alphabetical Order ssssssseesneesssesserrnensssnerrrrrnnnessee 99 14 3 NRS Summary Functional Assessment Scores Definitions cceeeeees 117 15 Additional Help With NRS CRE Orts cccccceeeceeeeeneeeeeeeeeeeeeeeeeeeeeeeeeeeeteeeeaaees 131 15 1 Demonstrated Help Tutorials iiss tauc052e5e Merk spec Shonacs cenv gets lonten Robrgegee douse cent aeeenieee 131 15 2 MicroStrategy Help Menuicistcceciie cn uetacieees i elaeenetiee eee leaks 131 We ONS a i acce had es Asst te ee cence ie cle he dN ae Nie Ns a aes 131 15 4 CIHI eReports Education Products ccceeeccecccceeeeeeeeeeeeseeeeeeeeeeeteessseaeeeeeeeees 131 15 5 COMTACE WSs esi ccctee cteea cs betes A E E te Mende detect EERE R teeter takes 131 Part oa POeNGICGS amp cea nce dan wae need Gun eats Gee cai Gn een 132 Appendix A NRS
94. ch user has the freedom to decide which attributes are included in each report Attributes are typically displayed in the rows or Page By axis of NRS eReports and are also sometimes used as selection prompts for example RCG prompt That is some of the attributes that can be displayed in the report are also used to select which data is used in that report For example a user could use the Bed Grouping attribute to choose only to include data from small facilities in the report Available attributes vary depending on report type Table 13 1 indicates the attributes that are available in the various NRS eReports Definitions descriptions and interpretation considerations for each attribute are listed in Section 13 2 Table 13 1 Availability of attributes across NRS eReports Report subtypes are abbreviated as follows AP Admissions Profile OD Outcomes at Discharge OF Outcomes at Follow Up RU Resource Utilization Report numbers are shown for Quick Indicators and Comparative Reports NRS Quick NRS Comparative NRS Analytical Attribute Indicators Reports Reports Admission Age Group AP 6 All Admission Class AP 3 AP ASIA Impairment Scale AP Body Mass Index BMI Group at Admission All Discharge Destination OD 4 OD OF Facility All All All Facility Program Type All Facility Type All All All Fiscal Year All All All CIHI 2015 71 NRS eReports Manual User Guide and Report Interpr
95. charge The difference between the scores on discharge and admission for the FIM instrument motor items that assess sphincter control Bladder Management Bowel Management CIHI 2015 127 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Available metrics average mean standard deviation minimum maximum Transfer Function Score at Admission Available in e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge The sum of the scores on admission for the FIM instrument motor items that assess ability to transfer from one surface to another Bed to Chair Wheelchair Transfer Toilet Transfer and Tub Shower Transfer Available metrics average mean standard deviation minimum maximum Transfer Function Score at Discharge Available in e NRS Analytical Reports gt Outcomes at Discharge The sum of the scores on discharge for the FIM instrument motor items that assess ability to transfer from one surface to another Bed to Chair Wheelchair Transfer Toilet Transfer and Tub Shower Transfer Available metrics average mean standard deviation minimum maximum Transfer Function Score Change Available in e NRS Analytical Reports gt Outcomes at Discharge The difference between the scores on discharge and admission for the FIM instrument motor items that assess ability to transfer from one surface to another Bed to Chair Wheelchair Transfer
96. che Print Display Print Options window Export Export report to Excel CSV HTML or plain text formats Export to PDF View report in PDF format based on options selected Full Screen Mode Enlarge the Report screen CIHI 2015 35 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Tools Toolbar Figure 7 3 The Tools Toolbar Grid Icons from left to right Save Save your result as a report template or filter Undo Undo the most recent action Redo Redo the most recent action Grid View report in grid format Graph View report in graph format Grid and Graph View report data in both grid and graph formats Report Objects Display or hide the Report Objects window Related Reports Display or hide the Related Reports window Page By Axis Display or hide the Page By axis View Filter Display or hide the View Filter window Report Details Display or hide the Report Details window Prompt Details Display or hide the Prompt Details window Show Pivot Buttons Display or hide the pivot buttons Show Sort Buttons Display or hide the Sort Options window You can sort based on up to three data elements in ascending or descending order Graph Zones Display or hide the Graph Zones window Report Options Open the Report Options window Data Toolbar Figure 7 4 The Data Toolbar Home Tools AA ml e oh ye BB OA ab ojl Icons from left
97. d Report Interpretation Guidelines April 2015 Interpretation considerations The Motor Function Score isolates the motor components of the FIM instrument and allows for a better comparison of motor function between FIM instrument assessments Available metrics average mean median standard deviation minimum maximum Motor Function Score at Discharge Available in e NRS Comparative Reports gt Outcomes at Discharge gt 2 Functional Status at Admission and Discharge From Facility e NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up e NRS Analytical Reports gt Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Follow Up This is the sum of the 13 FIM instrument elements 41 to 53 inclusive that assess various components of motor function self care sphincter control transfers etc at the time of discharge The Motor Function Score ranges from 13 to 91 and provides a score that describes a client s motor function based on the elements tested Inclusions exclusions Motor Function Score is calculated from discharge records containing complete FIM instrument Total Function Scores that is both motor and cognitive components Records for which no FIM instrument assessment has been completed for example records with Admission Class 4 Un planned Discharge are excluded Interpretation considerations The Motor Function Score isolates the motor components of
98. d rehabilitation beds At the end of 2013 2014 there were over 400 000 pairs of admission and discharge records that is complete episodes in the NRS database submitted by over 100 hospitals in nine provinces and covering a range of health conditions including strokes orthopedic conditions and amputations For additional information on the NRS or for additional NRS publications please write to nrs cihi ca or visit the NRS website at www cihi ca nrs CIHI 2015 v NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 About This Manual This manual is divided into three main parts Part 1 is the NRS eReports User Guide and comprises chapters 1 to 8 This first part has been developed to assist you in getting to know and navigate the NRS eReports system and teach you how to create manipulate and format reports The User Guide portion of this manual includes the following topics NRS eReports terminology How to create your own NRS reports How to change the format and content of reports How to save export and print reports and How to save reports for easy generation of quarterly updates Part 2 is the NRS Report Interpretation Guidelines and comprises chapters 9 to 15 This second part outlines the general format and content of reports that can be created in the NRS eReports environment Through the use of this part of the manual facilities can enhance the use of their created reports for policy d
99. delines April 2015 will be All Facilities as such an aggregated value for all Facilities will be displayed if no peer group is designated Define the Peer Group Based on Facility Type Choose to define the peer group by either general or specialty facility type If you choose this option DO NOT define peer groups based on either of the following two prompts Define the Peer Group Based on Number of Beds Choose to define the peer group by the number of rehabilitation beds If you choose this option DO NOT define peer groups based on either of the other two prompts This prompt e Offers beds broken down in groups of 1 10 11 20 21 30 31 40 41 50 51 75 76 100 101 200 200 e Allows multiple choices Define the Peer Group Based on Facility Name Choose to define the peer group by choosing one or more facilities by name or number If more than one facility is chosen values displayed in the Peer column of the report will reflect depending on which metric is being considered either a total or an average across all of the chosen facilities If you choose this option DO NOT define peer groups based on either of the above two prompts This prompt e Offers facilities participating in the NRS by name and number e Is sorted alphabetically by name and e Allows multiple choices Page By Axis The Page By axis at the top of each Comparative Report may contain any number of Page By
100. discharge for the FIM instrument motor items that assess basic activities necessary for daily personal care Eating Grooming Bathing Dressing Upper Body Dressing Lower Body and Toileting Available metrics average mean standard deviation minimum maximum Self Care Function Score Change Available in e NRS Analytical Reports gt Outcomes at Discharge The difference between the scores on discharge and admission for the FIM instrument motor items that assess basic activities necessary for daily personal care Eating Grooming Bathing Dressing Upper Body Dressing Lower Body and Toileting Available metrics average mean standard deviation minimum maximum Sphincter Function Score at Admission Available in e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge The sum of the scores on admission for the FIM instrument motor items that assess sphincter control Bladder Management Bowel Management Available metrics average mean standard deviation minimum maximum Sphincter Function Score at Discharge Available in e NRS Analytical Reports gt Outcomes at Discharge The sum of the scores on discharge for the FIM instrument motor items that assess sphincter control Bladder Management Bowel Management Available metrics average mean standard deviation minimum maximum Sphincter Function Score Change Available in e NRS Analytical Reports gt Outcomes at Dis
101. dologies used in other CIHI databases Available metrics average mean standard deviation minimum maximum Body Mass Index BMI at Admission Available in e NRS Comparative Reports gt Outcomes at Discharge gt 1 Client Demographics e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge BMI is calculated by dividing the client s admission body weight in kilograms by the squared value of the client s height in metres that is kg m BMI values are often grouped into four standard categories underweight lt 18 5 normal 18 5 24 9 overweight 25 30 and obese gt 30 Inclusions exclusions BMI is only calculated for clients with recorded values for height element 40A and weight element 40B on admission BMI data is only available in NRS eReports for fiscal years 2009 2010 and later due to changes in NRS coding specifications CIHI 2015 100 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Interpretation considerations BMI values are calculated for clients that have height and weight elements 40A and 40B data available regardless of the accuracy of the values coded for these elements As such some clients may have BMI values that seem unreasonable or unlikely This may be due to various measurement or coding issues e g submitting a weight measured in pounds instead of kilograms a height measured in inches instead of cent
102. e Available in e NRS Comparative Reports gt Admissions Profile gt 1 Admission by Referral Source e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge Describes the general sources of client referral to rehabilitation based on response coded for element 22 Referral Source The coding options for this element are 01 Self Family 02 Inpatient acute unit same facility 03 Inpatient acute unit different facility 04 Rehabilitation unit same facility 05 Rehabilitation unit different facility specialty or general facility 06 Ambulatory care service facility based CIHI 2015 81 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 07 Private practice primary care services for example MD PT 08 Drug dependency service 09 Community services including public health transportation services 10 Residential care facility includes long term care continuing care nursing home 11 Legal service police parole officer court 12 Educational agency 13 Home care agency 97 Other includes rehabilitation outreach services 50 Not available temporarily 70 Asked unknown For reporting purposes the responses have been grouped into categories as follows Acute care inpatient Referral Source 02 03 Other rehab inpatient Referral Source 04 05 97 Long term care Referral Source 10 Home community Referral Source 01 06 to 09 11
103. e Indicators Ottawa 1996 CIHI 2015 87 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Table 14 1 Availability of metrics across NRS eReports Report sub types are abbreviated as follows AP Admissions Profile OD Outcomes at Discharge OF Outcomes at Follow Up RU Resource Utilization Report numbers are shown for Quick Indicators and Comparative Reports NRS Quick NRS Comparative NRS Analytical Indicators Reports Reports Active Rehab Length of Stay Average Mean OD 5 RU5 OD OF RU Median OD Standard Deviation OD Minimum OD Maximum OD 25th Percentile OD 75th Percentile OD Active Rehab Length of Stay Efficiency Average Mean OD 5 RU5 OD OF RU Median OD Standard Deviation OD Minimum OD Maximum OD 25th Percentile OD 75th Percentile OD Admission Age Average Mean OD 1 AP OD OF Standard Deviation AP OD OF Minimum AP OD OF Maximum AP OD OF Body Mass Index BMI at Admission Average Mean OD 1 AP OD Median AP OD Standard Deviation AP OD Minimum AP OD Maximum AP OD 25th Percentile AP OD 75th Percentile AP OD CIHI 2015 88 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Table 14 1 Availability of metrics across NRS eReports Report sub types are abbreviated as follows AP Admissions Profile OD Outco
104. e By options at the top of the report to display only certain data ona particular page or c Choose to display the data in a grid table a graph or both grid and graph 7 Once the report contains the data that you are interested in and looks the way that you want you may choose to export save or print your newly created report For details about these options please refer to Chapter 8 CIHI 2015 31 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 6 5 How Do I Regenerate a Previously Created Report There are probably numerous times that you will want to regenerate a report that you have previously created rather than creating the report from scratch again NRS eReports makes this easy to do Previously created reports are stored in either My Reports provided that you have saved them there and or the History List provided that you have added them to the History List during or immediately after creation After navigating to one of these areas you can browse through the listing of reports and their descriptions until you find one of interest To run the report click on either the report s PDF link or its document icon The PDF link produces a static formatted version of the report The document icon gives you the flexibility to format and manipulate report objects Before being presented with the report you are first brought to the Wait Page 6 6 The Wait Page Upon answering prompts to c
105. e Help link in the top of this screen While this Help menu contains detailed information about all aspects of the MicroStrategy platform please note that because this is a generic MicroStrategy Help menu some of the information available may not be applicable to NRS eReports 15 3 FAQs From the Resources section in the bottom right corner of the NRS eReports Launch Page you can link to a collection of Frequently Asked Questions FAQs and their answers This FAQ list will grow over time as the NRS eReports system is used by more people 15 4 CIHI eReports Education Products CIHI produces a number of educational products to help support use of eReports For example O CIHI s General eReporting eLearning course An Introduction to CIHI eReporting may provide a useful tool for learning fundamentals of eReporting and MicroStrategy To access these products visit https learning cihi ca 15 5 Contact Us For client support please contact the NRS team at nrs cihi ca or submit a question via the eQuery online tool CIHI 2015 131 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Appendix A Appendix B Appendix C Appendix D Appendix E Part 3 Appendices NRS eReports Folder Structure NRS Glossary History of Changes to the NRS eReports Alignment With Previous NRS Quarterly Comparative Reports Notes for CIHI Portal Users CIHI 2015 132 NRS eReports Manual User G
106. e at www cihi ca nrs as well as the annual Data Quality Report for Provinces Territories directed to each province and territory s deputy minister of health Facilities are encouraged to promote internal data quality with regard to the NRS through in house training and retesting regular data quality checks and ongoing communication with the NRS team at CIHI 9 3 Submission Timelines The table below shows timelines for submission of data to CIHI for the NRS Dates are consistent from year to year Note If a deadline date falls over a weekend or holiday records that are submitted by the deadline will be processed on the next working day For the Error Correction Deadline the data cut is typically taken the morning of the next working day following a date that falls on a weekend or holiday Any records submitted by the deadline date will be processed prior to taking the data cut CIHI 2015 52 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 NRS Submission Timelines Submission NRS eReports Quarter Reporting Period Deadline Data Updated Quarter 1 April 1 to June 30 July 31 Approximately A Quarter 2 July 1 to September 30 October 31 5 weeks after the Quarter3 October 1 to December 31 January 31 cere Quarter 4 January 1 to March 31 April 30 ees Note This date may vary slightly according to CIHI s internal production schedule t The NRS quarterly
107. eReports Folder Structure ec cceeessscceeeeeseeeeeeeesneeeeessaneeeeeesneeeeeennees 133 Appendix B NRS GlOSSary cccccccccceeeeeeeeeeccaeceeee eee eeeeaaaaaaaaeeeeeeeeaaaaaaaaeeeeeeeesessssaaaeeeeeees 137 Appendix C History of Changes to the NRS eReports ccccceeeeeeeeeeeteeeeeeeeeeeeeeeeeneeeeeees 146 Appendix D Notes tor CIHI Portal Users e c cin cide been Meee aed 150 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 About CIHI The Canadian Institute for Health Information CIHI collects and analyzes information on health and health care in Canada and makes it publicly available Canada s federal provincial and territorial governments created CIHI as a not for profit independent organization dedicated to forging a common approach to Canadian health information CIHI s goal to provide timely accurate and comparable information CIHI s data and reports inform health policies support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health About NRS The National Rehabilitation Reporting System NRS was developed by CIHI in 2001 to support data collection by hospitals for inpatient rehabilitation clients who are mainly age 18 and older The rehabilitation services are provided in specialized rehabilitation hospitals and in general hospitals within rehabilitation units programs or designate
108. each repeated attribute value By clicking on the plus or minus sign you can choose to display or hide data at lower levels of detail e Show Banding This option allows you to apply alternating background colours for each row of a report Each row will then appear with different bands of colour This can make it easier to read the data table e Show Attribute Form Names This option allows you to display the full names that are used for some of the attributes that might be included in your report This feature is likely only of interest for more advanced users and does not provide much added functionality for most users CIHI 2015 40 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 e Remove Extra Column In grid reports removes the hidden column that contains a header entitled Metrics Removing this column does not fundamentally change the grid but may be desirable to some users e Full Screen Mode This check box allows you to specify whether or not the report should always open in full screen mode Steps to Formatting a Grid For advanced formatting options 1 Display the report in grid view 2 Open the Format drop down menu 3 Select Advanced Formatting 4 Select the portion of grid you want to format 5 Click the appropriate tab to define format configuration for Font Number Alignment and Colour and Lines Click Apply for each configuration Click OK to accept changes
109. ection of appropriate peers Export PDF 2 The Comparative Reports folder Figure 6 8 displays four categories of Comparative Reports i Admissions Profile ii Outcomes at Discharge iii Outcomes at Follow Up and iv Resource Utilization For a listing of the Comparative Reports that are available in each of the four categories refer to Appendix A Folder Structure For a more detailed description regarding interpretation of each Comparative Report consult Chapter 11 Click on the category of Comparative Reports corresponding to the report you would like to create CIHI 2015 27 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Figure 6 8 The Comparative Reports folder contains four categories of reports Admission Profile Outcomes at Discharge Outcomes at Follow Up and Resource Utilization i 2 NRS Comparative Reports Discharge 3 Depending on which category you selected you will see a screen providing between five and seven different Comparative Reports see chart in Appendix A To generate a report click on the desired report icon If you cannot find the report that you are looking for and would like to select from a different category of Comparative Reports instead simply click on the NRS Comparative Reports navigation link at the top of the screen in the trail of breadcrumbs navigation bar and then make a different category selection 4 Regardless of which Compa
110. ed Reported client numbers may vary between different generated reports depending on whether a facility is submitting data under Option 1 or Option 2 Refer to the Data Submission Options section to review these options The total numbers in the various reports may differ between indicators due to missing data For example if a discharge FIM instrument assessment is not completed for a client due to an Un planned Discharge 19A Admission Class 4 or other reason that record is excluded from the calculation of all Function Score indicators which require both complete admission and discharge FIM instrument scores other than those in Admissions Profile reports Admissions Profile reports are based on data provided at admission only and may therefore include records that end up not being included in some Outcomes at Discharge reports Therefore the total N value for any column reporting Function Scores may be less than the total N values reported for other indicators such as Discharge Destination or Average Onset Days where complete Function Scores are not required Similarly for applicable indicators records containing Unknown and Missing values are excluded from the indicator calculations Refer to Chapter 14 for further detail on inclusions and exclusions for the various metric calculations Note Unknown and Missing values are excluded from calculations but they are included in the denominator for percentage calculations For this re
111. ed as a measurement tool screen or flag that is used as a guide to monitor evaluate and improve the quality of client care clinical support services and organizational functions that affect outcomes In the NRS eReports each indicator is associated with one or more metrics This term refers to the numerical data such as percentages counts N or a variety of summary statistics for example average mean median standard deviation that summarize each of the demographic clinical and administrative indicators available in the NRS eReports Some of the metrics listed in the NRS eReports have been derived from two or more NRS data elements For example Length of Stay is calculated using the Admission Date Discharge Date Service Interruption Start Date and Service Interruption End Date The metric definitions included in this document identify the NRS data elements that are used in the calculation For further information on coding and interpretation of individual data elements refer to the most recent version of the NRS Rehabilitation Minimum Data Set Manual Tables 14 1 and 14 2 list the metrics that are available for the various NRS eReports Definitions descriptions and interpretation considerations for each metric are listed in Section 14 2 1 CIHI National Consensus Conference on Population Health Indicators 1999 2 Canadian Council on Health Services Accreditation A Guide to the Development and Use of Performanc
112. eeeeenseeneeeneeenee 51 9 Data Submission and Reporting ccccccceeeeeeeeeeeeeeeeeeeeeeeeeesensaaaeeeeeeeeeeeeenaaaaes 52 9 1 Population of Reference ss cinch cer eee ei cae a een ennen 52 9 2 Data Quality irl the NRS ienien tevaitecs eect reo ies eee ee bee O lowers 52 9 3 SUDMISSION TIMINGS S nnennpni a A E E ER 52 9 4 Data Submission Options ssssssseeeeeesseeenrrrrtrtsstrttrrrntttssttrrrnrnnnnsstrnnnnnn renser ennen 53 9 5 Definition of a Complete ReECOrd vacivssiecc ress nesivieteehke nese nenenericednhcnce 54 10 In Depth NRS Quick Indicators 2xcscke statue tid gecietagded dic hedeleale heddelengle danas 57 10 1 ONSTAAN E E E EE E E A E E E EE A EET 57 10 2 Attributes and Metrics Available in NRS Quick Indicators 0 0 0 0 ceeeeeeetereeeees 61 11 In Depth NRS Comparative Reports 4 scent dicniatiete ie ntaeh eas 62 11 1 OVOIVIOW srera e a E E E ER E E RE ore ee 62 11 2 Attributes and Metrics Available in NRS Comparative Reports ceeee 64 11 3 Admissions Profile Comparative Reports cc cccceeeeeeeeeeeeneeeeeeeeeeeteeeenneeeeeeees 64 11 4 Outcomes at Discharge Comparative Reports cccceeceeeeeeeeeeeeeeeeeeeeeenneeeeeees 65 11 5 Outcomes at Follow Up Comparative Reports 0 0 0 0 cccceccecceeeeeeeeeeeeeeeeeestneeeeeeees 65 11 6 Resource Utilization Comparative Reports c ccccceceeeeeeeeeeneeeeeeeeeeeeeeeennneeeeeeees 66 12 In Depth NRS Analytical Reports eiccss
113. eived inpatient rehabilitation services from participating facilities across Canada At the time of printing participation in the NRS remains voluntary for all provinces and territories except Ontario As such it cannot be stated that the data in the NRS is representative of all inpatient rehabilitation activity in Canada Participating facilities submit data to CIHI on a quarterly basis NRS eReports generated during a particular reporting quarter include data from all records that were successfully submitted prior to the corresponding quarterly deadline The data contained within these eReports is aggregate data from a specific time period as chosen by the user at the time of report creation 9 2 Data Quality in the NRS Data quality is an important component of the NRS and is primarily addressed by CIHI through the following mechanisms Clinical training sessions with online testing requirements Documentation of the NRS data elements and guidelines for coding Logical and sequential checks built into vendor software and during data processing at CIHI NRS Data Submission eLearning module available online at https learning cihi ca Submission error reports generated within two days of data submission Client support for clinical coding and data submission Ongoing monitoring of data submissions by the NRS team at CIHI and NRS Data Quality documentation including an annual assessment of data quality in the NRS data set publicly availabl
114. ernatively if there is no denominator value then the resulting percentage will be shown as a blank space that is a null value rather than a zero For example if Clients Reporting Improved Health Status Count was zero but Clients Followed Up Count was not zero then the value calculated for Clients Reporting Improved Health Status Percent will be 0 0 If however the value for Clients Followed Up Count was also zero then the calculated percentage will be a null value and will be displayed as a blank cell or a cell with a dashed line 5 7 Drilling Drilling refers to looking at your data at a different level of analysis For instance you might drill down to look at more specific groupings of data If data is shown for a particular fiscal year for example you might drill down to view the data at the level of reporting periods that is quarters Alternatively you could drill down from national level data to the provincial level Drilling up refers to looking at less specific larger groupings of data For instance you might choose to collapse data across various age groups if age was not an important factor in your analysis In this case you are drilling up from the level of age groups Likewise if you were only interested in overall number of clients requiring rehabilitation for a particular impairment you might drill up from the level of sex that is collapse data across both sexes
115. erpretation Guidelines April 2015 Undo Undo the most recent action Redo Redo the most recent action Grid View report in grid format Graph View report in graph format Grid and Graph View report data in both grid and graph formats Report Section Select rows columns or metrics to be formatted Header or Values Select portion of grid header or values to be formatted Font Style Select font style Font Size Select font size Bold Display selection in bold Italic Display selection in italic Underline Underline the selected grid portion Left Align selection to the left Centre Align selection in the centre Right Align selection to the right Currency Style Display selected numerical data to dollar amounts Percent Style Display selected numerical figures in percentage format Comma Style Round selected numerical data to nearest full integer Increase Decimal Increase the number of decimal places in the selected data Decrease Decimal Decrease the number of decimal places in the selected data Fill Color Set a background colour for the selected cells in the grid Line Color Set the line colour for the selected cells in the grid Text Color Set the text colour for the selected cells in the grid Borders Set borders around the selected cells in the grid Border and Line Style Set the border styles around the selected cells in the grid Advanced Grid Formatting Open the Ad
116. ers Grid display Change the default Autostyle that is applied when a report opens as well as the maximum number of rows and columns that will appear on one page Export reports Change the default export format for grids graphs and documents Print reports PDF Create custom headers and footers change PDF orientation and reset the default scale for PDFs Drill mode Select whether to keep parent attributes or thresholds when drilling in a report Prompts Choose whether to view report prompts all on one page or on separate pages Report services Customize advanced display properties Security Set preferences upon logout includes pending requests and History List behaviour How to work with user preferences 1 Navigate to the Preferences page 2 From the left hand side of the screen select the type of preference to manipulate for example General Folder browsing Printing Grid display 3 Ona particular preference page define the new preference modifications Click Apply 5 Repeat steps 2 through 4 until all desired changes have been made R 4 8 Search Box This tool allows users to search for existing reports that are saved under Shared Reports or My Reports Advanced search options include the ability to specify report type date created or report owner The following two subsections describe the two types of searching that are possible in NRS eReports Quick Search A simple search is performed by typ
117. es twice at both admission and discharge As such some post admit comorbidities may not be true post admit comorbidities Post admit comorbidities are likely over estimated Care should be exercised when comparing this indicator between facilities jurisdictions Available metrics count Pre admit Comorbid Health Condition ICD 10 CA Available in e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge Existing health conditions present at the time of rehabilitation admission that affect the client s health functional status and resource requirements during the rehabilitation program This includes pre admit complications and or comorbid conditions that delay interrupt or compromise effectiveness of the rehabilitation program or represent high medical risk disorders e g previous Cardiac arrest pulmonary embolus ruptured aneurysm The number of Pre Admit Comorbid Health Conditions coded at admission to inpatient rehabilitation A total of 15 Pre Admit Comorbid Health Conditions can be coded at admission for each client Inclusions exclusions Pre Admit Comorbid Health Conditions are only mandatory to record if they are existing health condition s present at the time of admission to facility unit that affect the client s health functional status and resource requirements during the rehabilitation program Interpretation considerations Pre Admit Comorbid Health Conditions are meant to reflect
118. etation Guidelines April 2015 NRS Quick NRS Comparative NRS Analytical Attribute Indicators Reports Follow Up Living Arrangements OF 1 OF Follow Up Living Setting OF 2 OF Most Responsible Health Condition ICD 10 CA AP OD Chapter Number of Beds All All Post Discharge Living Arrangements OD Pre Hospital Living Arrangements AP 4 AP Pre Hospital Living Setting AP 5 AP Primary Reason for Waiting for Discharge OD Referral Source AP 1 AP OD Rehabilitation Client Group RCG QI 1 9 AP OD OF All Rehabilitation Group RG RU 1 5 All Rehabilitation Patient Group RPG RU 1 5 All Sex AP 6 All 13 2 NRS Attribute Definitions in Alphabetical Order This section provides a description of attributes found in various NRS eReports and indicates the reports in which each can be found Attributes are listed in alphabetical order Admission Age Group Available in e NRS Comparative Reports gt Admissions Profile gt 6 Age at Admission to Facility e All NRS Analytical Reports Age groupings defined by the NRS This allows data to be grouped by age range rather than presenting data for each individual age Data included in each age group is based on age at admission calculated by subtracting element 8 Birth Date from element 21 Admission Date CIHI 2015 72 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Interpretation considerations Admissi
119. evelopment and decision making in rehabilitation The Report Interpretation Guidelines portion of this manual includes the following topics e Data submission details e Detailed descriptions of available reports e Descriptions of NRS attributes and metrics indicators and e Where to get further help with NRS eReports Part 3 is a collection of Appendices that may assist in navigating using and understanding the NRS eReports All references to facilities made in this manual refer to rehabilitation facilities or rehabilitation units participating in the NRS NRS data elements in this manual are generally identified by name and or number For example data element 19A Admission Class Refer to the most recent version of the NRS Rehabilitation Minimum Data Set Manual for complete information on the individual data elements in the NRS Throughout this manual the term assessment is used interchangeably with record to refer to the individual set of information collected at admission discharge or follow up for a unique client A complete admission and discharge assessment record pair constitutes a rehabilitation episode The term FIM instrument assessment is used to refer specifically to information collected with only the FIM instrument A glossary of terms commonly used in the NRS is available in Appendix B Feedback on this manual is welcome and can be directed to the NRS team at nrs cihi ca CIHI 201
120. gements 5 Admission by Pre Hospital Living Setting 6 Age at Admission to Facility 7 Functional Status at Admission to Facility Outcomes at 1 Client Demographics Facility Discharge 2 Functional Status at Admission and Fiscal Year s Discharge From Facility RCG s 3 Clinical Outcomes at Discharge Peer Group s 4 Discharge Destination 5 Length of Stay and Service Interruptions Outcomes at 1 Follow Up Living Arrangements Facility Follow Up 2 Follow Up Living Setting Fiscal Year s 3 Client Follow Up Counts RCG s 4 Functional Status at Follow Up Peer Group s 5 Clients Achieving Partial or Full Community Re Integration Resource 1 RPG Patient Days Report Facility Utilization 2 RPG Patient Days Report Most Fiscal Year s Recently Completed Fiscal Quarter RPGs RGs 3 RPG Case Mix CMI Report Original Methodology Peer Group s 4 RPG Case Mix CMI Report Current Methodology 5 Functional Status Gain by RPG 6 Regional Case Mix Report Original Methodology 7 Regional Case Mix Report Current Methodology CIHI 2015 134 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Report Type Subfolders Reports Available Display Data By NRS Analytical Admissions 1 Admissions Profile Peer Comparisons Any atripes Reports Profile w bok 2 Admissions Profile MuIltiple Facilities Outcomes at 1 Outcomes at Discharge Any attributes Discharge Peer Comparisons 2 Outcomes at Discharge
121. gt Since there is a screening question to determine if the CIHI Cognitive assessment is required the total number of clients reported in this indicator may be less than the number reported in the FIM instrument functional scores gt The scoring scales for the FIM instrument and CIHI Cognitive assessments are intentionally not identical As such the two scores cannot be compared but rather should be used together to obtain a more complete picture of a client s functional level gt CIHI Cognitive elements with a score of 8 are recoded as 1 for the purposes of this calculation gt Recently Uniform Data System for Medical Rehabilitation UDSmr completed a Rasch analysis on the CIHI Cognitive elements on a cohort of NRS stroke clients Overall it found these six elements to have very good reliability and significant inter item correlation However it was noted that the Financial Management element may be measuring another construct than what it is intended to measure and that the Orientation element may be too easy Consequently CIHI will investigate modifying the scale in the future CIHI Cognitive Score at Admission Available in 3 CIHI Pilot Project Report Rehabilitation Data Standards for Canada February 1999 CIHI 2015 124 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 e NRS Comparative Reports gt Admissions Profile gt 7 Functional Status at Admission to Facility e NRS
122. horizontal and vertical alignment styles and word wrapping Colour and Lines The Colour and Lines tab allows you to select any object and object component such as header or values on the report and add a border Options include border line style colour and thickness Aside from the Advanced Formatting window there is also a Resize Columns and Rows window available from the Format menu and a Report Options window available from the Tools menu and toolbar Both are described below Resize Columns and Rows This window allows you to resize the report to fit the browser window resize the report to the width of the data in each column or choose a custom size for each column and row Report Options Opening the Report Options window allows the following functions for formatting a report These options can also be individually accessed from the Grid toolbar e Merge Row and or Column Headers This option allows you to either show all row and or column headers or merge the values of repeated row and or column headers e Lock Row and or Column Headers This option allows you to lock both the row and column headers This feature is helpful if you have a very large report and want to be able to scroll through it while still being able to see the labels at the top of the column or side of the rows e Outline This option provides a more interactive way of viewing your data A series of boxed plus or minus signs appear to the left of
123. ibutes available are detailed in the NRS data dictionary Reporting Provinces Territories There are currently nine provinces submitting data to the NRS British Columbia Alberta Saskatchewan Manitoba Ontario New Brunswick Nova Scotia Prince Edward Island and Newfoundland and Labrador For more information about the NRS or any of its data or reports please contact nrs cihi ca or visit www cihi ca nrs CIHI 2015 152
124. ications and or comorbid conditions that delay interrupt or compromise effectiveness of the rehabilitation program or represent high medical risk disorders e g previous cardiac arrest pulmonary embolus ruptured aneurysm Pre Hospital Living Setting Physical environment the client was living in prior to his her admission to hospital for rehabilitation For example a private home or a residential care facility Primary Reason for Waiting for Discharge The primary reason a patient waited to be discharged from a facility agency CIHI 2015 142 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Private Practice An independent practice to whom the client may be referred at time of discharge for related services following the rehabilitation episode for example a physician or physiotherapy clinic Problem Solving FIM instrument Includes skills related to solving problems of daily living and generally involves five steps 1 recognizing that a problem is present 2 making appropriate decisions 3 initiating steps and readjusting to changing circumstances 4 carrying out a sequence of events and 5 evaluating the solution Prompts Prompts are used to dynamically modify the content of a report at run time When creating a report you will be prompted for information that will tell the application what kind of report to produce For example you might be prompted to select a partic
125. ics that are available how many prompts you want to answer on the Prompt screen whether or not you want to be able to choose your peer group and whether or not you want the ability to drill into the data Below are some sample guidelines to assist your decision making e For quick access to graphical information about common indicators consider NRS Quick Indicators e To define your peer group and or drill into data consider NRS Comparative Reports e To have access to all possible metrics and attributes and thus have the greatest flexibility in creating reports consider NRS Analytical Reports CIHI 2015 22 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 6 2 Creating NRS Quick Indicator Reports To create a Quick Indicator report 1 From the NRS eReports Launch Page see Chapter 3 or the NRS eReports folder see Section 6 1 click on NRS Quick Indicators Figure 6 2 NRS Quick Indicators can be accessed from the NRS eReports folder NRS eReports 1 NRS Quick Indicators Owner Administrator Modified 7 14 09 7 16 30 AM View at a glance reports of several Admission Discharge and Follow up Indicators for each Rehabilitation Client Group at the Facility Peer and National levels for the last 5 fiscal years Peer Groups are based upon General Specialty facility types 3 NRS Analytical Reports Owner Administrator Modified 7 14 09 7 16 31 AM Build your own rep
126. ients with a Complete Admission and Discharge CIHI Cognitive Instrument Assessment Available in e NRS Comparative Reports gt Outcomes at Discharge gt 1 Client Demographics e NRS Analytical Reports gt Outcomes at Discharge The total number of clients for which a CIHI Cognitive assessment was performed at the time of discharge Available metrics count CIHI 2015 108 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Clients with a Complete Discharge FIM Instrument Assessment Available in e NRS Comparative Reports gt Outcomes at Discharge gt 1 Client Demographics e NRS Comparative Reports gt Resource Utilization gt 5 Functional Status Gain by RPG e NRS Analytical Reports gt Outcomes at Discharge e NRS Analytical Reports gt Resource Utilization The total number of clients for which a FIM instrument assessment was performed at the time of discharge Available metrics count Clients with Service Interruptions Available in e NRS Comparative Reports gt Outcomes at Discharge gt 1 Client Demographics e NRS Analytical Reports gt Outcomes at Discharge The total number of clients who had at least one service interruption in a particular reporting period Occurs when a client is unable to participate in the rehabilitation program due to a health condition that may or may not result in a transfer out of the rehabilitation bed or unit Service interruptions are generally c
127. igation bar also includes Back and Forward navigation buttons These aspects are described in the next chapter of this guide CIHI 2015 8 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 4 Folders Navigation and Action Toolbars Within all aspects of the NRS eReports navigation and action toolbars are displayed and some toolbars are more permanent than others The Navigation toolbar at the top of the screen will be displayed at all times throughout eReports At the top of all NRS eReports screens you will find a navigation toolbar Figure 4 1 A brief description of the items found in the navigation toolbar is provided below Report folder screens also include an action toolbar this is discussed in Section 4 11 Figure 4 1 The navigation toolbar appears at the top of each NRS eReports page NRS Launch Page Fa i al alala A 4 1 CIHI Projects Dropdown Menu The CIHI logo FR located in the upper left corner of the screen is a dropdown menu giving you access to project folders and reports Click the logo to expand the menu Figure 4 2 The CIHI Projects Dropdown Menu expanded Projects Home Shared Reports My Reports History List Preferences 5 ft Q A Cc Logout 4 2 Projects Select the Projects option from the CIHI Projects Dropdown Menu to access the eReporting Gateway Page Projects Page at any time CIHI 2015 9 NRS eReports Manual User Guide
128. imetres etc Available metrics average mean standard deviation minimum maximum 25th percentile 75th percentile Case Mix Metrics Available in e NRS Comparative Reports gt Resource Utilization gt RPG Case Mix Reports e NRS Analytical Reports gt Resource Utilization gt RPG Case Mix Reports Case Mix metrics may be found in Current Methodology or Original Methodology Comparative Reports or may be named as such in the Analytical Reports Current Methodology values are based on the current rehabilitation cost weights and outlier trim points being used in the RPG Case Mix Methodology visit www cihi ca casemix for more information on values that are currently being used Original Methodology values for a particular fiscal year are based on the rehabilitation cost weights and outlier trim points that were in effect during that fiscal year The Current Methodology values permit users to analyze trends over time whereas the Original Methodology values permit users to view the data that would have been seen in reports created in those fiscal years Note that for the current fiscal year based on the above mentioned methodology reports generated using the Original Methodology and the Current Methodology will be the same Case Mix Clients COUNT The number of clients included in the RPG Case Mix Reports Case Mix Case Mix Index AVG This overall facility indicator reported in the
129. in Dysfunction Neurological Conditions Spinal Cord Dysfunction Amputation of Limb Arthritis E Facility g Pain Syndromes E Peer Orthopedic Conditions BAI Cardiac Pulmonary Major Multiple Trauma Debility Medically Complex 0 0 40 0 80 0 120 0 Score 7 item s found E Report Objects A Belated Dannrte Circled numbers correspond to in text descriptions provided below CIHI 2015 33 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 There are nine key areas on the Report screen most of which may be made visible or hidden using the Tools pull down menu Menu Bar This bar supports four drop down menus Home Tools Data and Format You will learn more about features available through these menus in this and the following sections Toolbar The buttons on these toolbars facilitate formatting and analysis of reports The buttons that are available depend on which toolbar is visible at the time and this can be changed by clicking on the Home Tools Data Grid Graph and Format menu tabs immediately above the toolbar You will learn more about this toolbar in Section 7 2 Report Object Browser This window contains a Report Objects tab that displays the objects that make up the report that you are viewing The information in this window may not significantly assist the average user in creating reports Report Details This window displays all the constraints that
130. in Syndromes Orthopaedic Conditions Cardiac Pulmonary Burns Major Multiple Trauma l Debility Medically Complex 50 60 70 i a N m w a aN a CIHI 2015 59 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Figure 10 2 Example of the Data Quality Indicators Report GROUPING Fiscal Year 2010 2011 v 10 Data Quality Indicators Report 2010 2011 Facility REHAB HOSPITAL Facility Type General Facility Facility Peer National N N N 2010 2011 Q4 Unknown Referred to Facility Number 0 0 0 117 9 3 171 6 8 Unknown Health Card Number 0 0 0 14 0 4 24 0 3 Unknown Date Ready for Admission 89 100 0 368 10 6 1161 14 8 2010 2011 Q3 Unknown Referred to Facility Number 0 0 0 122 8 7 194 7 0 Unknown Health Card Number 3 0 9 13 1 0 22 0 2 Unknown Date Ready for Admission 80 100 0 377 9 8 1287 14 6 2010 2011 Q2 Unknown Referred to Facility Number 0 0 0 162 12 2 266 10 3 Unknown Health Card Number 3 1 0 131 1 0 584 1 7 Unknown Date Ready for Admission 0 0 0 16 04 22 0 3 Prompt screen For all NRS Quick Indicator reports the user will be presented with a prompt for Facility only The prompt has the following instructions and an answer to the prompt is required 1 Select Your Facility required Select the facility for which you would like to run the report This report allows only one selec
131. ing the word or phrase you are looking for in the Quick Search box located in the upper right hand corner of every page The search returns a list of all objects that match the search string You can then interact with the object the way you would in any other area of NRS eReports for example open a folder or execute a report CIHI 2015 13 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 To perform a quick search 1 Enter the search keyword s in the Quick Search textbox 2 Click the Submit Search icon that is the magnifying glass icon to the right of the search box 3 Interact with the search results Advanced Search An advanced search allows for additional search criteria beyond a simple text string To perform an advanced search 1 Navigate to the Search Page by clicking on the magnifying glass icon to the right of the search box Type in your desired keyword s or phrases Define the search criteria Location Object Type Owner Date Created Modified etc Enter a brief description optional Click the Search button Interact with the search results 4 9 Help Help provides you with access to available help files and how to demonstrations Chapter 15 for more information about getting additional help with NRS eReports oak Wh 4 10 Logout Allows you to log out of your NRS eReports session 4 11 Current Location Trail of Breadcrumbs Toolbar You can always
132. ion Guidelines April 2015 Table of Contents About CIH sia a cei pa Bake aed tb aie casa Bk a i a Ray Bs che tad ist meme v ADOUE N m EE EA ETE S TE E E ES S E S E E S EE E S E v ADOUL THAIS Man dli sercan A A E a ATE vi Part 1 NRS eReports User Guide esi cncsisciivesol cia ndetvandl okcasuiadiva tdelaiap hese seaukennelalads 1 1 Introduction to NRS Ghepons csc iascacs aeueees eat eadaeendeaa wad 2 1 1 What Is the NRS eReports System 0 ce ceeececcceeeeeeeeeeeeeseaaeeeeeeeeeeessesaaaeeeeeees 2 1 2 Who Has Access to NRS eReports ic cccdecteeistded dikes aiviaie tales 2 1 3 BEIE AV clas sas eo ae Ge ae ee ete es Oe ere aan eee ace a occ 3 2 Accessing NRS eReports isaac gractaet desc aceacemet sordoet reecinc ea sieeetegencedantectennciacaete 4 2 1 Computer REQuIrgMGNISi 24 c5 aie Ohctetri ae i eee Le eR 4 2 2 ObaINING ACCESS iee e e ER suet AE E E EEE RE R TERETE 6 2 3 Logging in From the CIHI Website ccccccceeeeeeeeeeeeneeeeeeeeeeeeeeenaaaeeeeeeeeteneesaaaaes 6 3 NRS eReports Launch Page ssseseeneeeeseoeeeenrrnrrssrrrrtrrnnnrrsrrrrnnrrnnreererrenennnreseeeenne 7 3 1 OQVOIVIQW es iior nae ia eaea E aa R aa E E E E EE a EE ieee tensa 7 4 Folders Navigation and Action Toolbars ssesssseesnessseeenerrnresserrnrrnnresserrrrrnn 9 4 1 CIHI Projects Dropdown Menu sssssssersesssssesrrrnrrtsstrrnrrrnnressrtrrnrrnnntssrtrrerrnnnenent 9 4 2 Projects O eared eu Sones Deere aa Sousa E Soe ee 9 4 3 OMG
133. ion on which the metric is based See section 14 3 for a more thorough description Throughout Jan 2011 New Case Mix methodology Introduction of per diem short stay cost weights and short stay trim points that vary depending on RPG new rehab cost weights and long stay trim values RU Reports Apr 2011 LOS and Case Mix LOS metrics changed to accommodate same day admit discharge episodes Clients admitted and discharged on the same day receive an LOS of 1 day instead of 0 days Throughout Apr 2011 New User Defined NRS eReports folder added allowing NRS eReports users to create save and share reports with other users Shared Reports Sept 2011 Two new regional case mix reports introduced CR RU 6 CR RU 7 Sept 2011 Rehab Client Subgroup ID code added to eReports When drilling from RCG to RC Subgroup can now see the numeric code as well as the subgroup name Throughout Dec 2011 Calculation of Active Rehab LOS changed to include all discharged clients rather than only those for whom Date Ready for Discharge was coded For those with Date Ready for Discharge not coded date assumed to be the same as Discharge Date CR OD 5 CR RU 5 AR OD AR OF AR RU Dec 2011 Added MEDIAN metrics for Function Score Change indicators Previously unavailable AR OD AR RU Dec 2011 Introduced COUNT metrics for Total Service Interruption Days and LOS indicators Previo
134. ires completion of all CIHI Cognitive elements 64 to 69 inclusive on both the admission and discharge assessments Inclusions exclusions Includes all records for those older than 13 years of age where element 19A Admission Class is initial rehabilitation continuing rehabilitation short stay or readmission class and element 63 Presence of Cognitive Communication Activity Limitations is coded as Yes and element 79 Glasses Hearing Aid Flag is coded as No or left blank Interpretation considerations Change in function indicators are expressed as averages A positive value indicates a score increase and a negative value indicates a score decrease Available metrics average mean median standard deviation minimum maximum percent percent standard deviation Self Care Function Score at Admission Available in e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge The sum of the scores on admission for the FIM instrument motor items that assess basic activities necessary for daily personal care Eating Grooming Bathing Dressing Upper Body Dressing Lower Body and Toileting CIHI 2015 126 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Available metrics average mean standard deviation minimum maximum Self Care Function Score at Discharge Available in e NRS Analytical Reports gt Outcomes at Discharge The sum of the scores on
135. ischarged Home Who Were Home Prior to Admission Across Rehabilitation Client Groups RCGs e NRS Analytical Reports gt Outcomes at Discharge This indicator looks at the percentage of clients returning home on discharge from rehabilitation who were living at home prior to admission Requires completion of 14 Pre Hospital Living Setting and 15 Post Discharge Living Setting Inclusions exclusions The numerator for the percentage calculation includes all records in which both the Pre Hospital Living Setting and the Post Discharge Living Setting 1 or 2 or 3 home The denominator is the number of discharged clients that had admission records with Pre Hospital Living Setting 1 or 2 or 3 Clients with Admission Class 4 or Discharge Reason 8 are excluded from this denominator Available metrics count percent Clients Followed Up Available in e NRS Comparative Reports gt Outcomes at Follow Up gt 1 Follow Up Living Arrangements e NRS Comparative Reports gt Outcomes at Follow Up gt 2 Follow Up Living Setting e NRS Analytical Reports gt Outcomes at Follow Up Clients who received a follow up assessment in a particular reporting period Available metrics count percent Clients Hospitalized Since Discharge Available in e NRS Comparative Reports gt Outcomes at Follow Up gt 3 Client Follow Up Count e NRS Analytical Reports gt Outcomes at Follow Up The number and percentage of follow up clients with data element 73A H
136. ital Living Arrangements provides information on the home environment prior to admission and can be compared to the post discharge environment in the measurement of outcomes Primary Reason for Waiting for Discharge Available in e NRS Analytical Reports gt Outcomes at Discharge Describes the distribution of clients by primary reason waiting to be discharged from a facility agency based on the response choice for data element 90A Primary Reason for Waiting for Discharge The response choices for this data element are Location 1 1 Assisted living supportive housing 1 2 Residential care LTC nursing home CIHI 2015 80 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 1 3 Complex continuing care chronic care 1 4 Acute care 1 5 Transitional care convalescent care 1 6 Boarding house rooming house 1 7 Inpatient mental health care 1 8 Palliative care 1 9 Other location Services 2 1 Facility based ambulatory care 2 2 Private pay therapy nursing personal support 2 3 Addiction services 2 4 Community services includes transportation 2 5 Home care 2 6 Other services Home Modifications Equipment 3 1 Home modifications 3 2 Equipment e g power wheelchair 3 3 Other home modifications equipment Personal 4 1 Informal support 4 2 Other personal 70 Unknown Inclusions exclusions Response code 70 Unknown is included in the denominator for percentage calculations Referral Sourc
137. itation services in Canada The number of facilities participating in the NRS can be determined from the graphs that are presented on the NRS eReports Launch Page These three levels of metrics are sometimes further split into two columns N which refers to a number or count and percent which is the percentage of the total column that N represents When N is reported by itself it refers to the number of clients or the number of days for instance When N and percent are both reported in a row N is the number of client records included in the numerator for the percentage calculation Refer to individual metric definitions in Chapter 14 for more details on specific calculations A Note About Rounding By default mean median and percent values in NRS eReports are rounded to the nearest single decimal place Due to rounding of values an indicator s individual percentage value may not exactly add up to the total percentage at the bottom of the column but it is generally within 1 to 2 of the total percentage A Note About Zero Versus Null Percentages You may encounter instances in which a percentage metric is displayed as zero that is 0 0 and other instances in which no percentage is shown at all for a particular level of attribute that is there is an empty cell in the table The former indicates that the numerator in the percentage calculation is zero or blank but that there is a non zero value for the denominator Alt
138. ith stroke clients in the higher RPGs and these two RPGs are differentiated solely by the client s age The higher numbered RPGs 1160 1150 will include clients with higher admission scores relative to the other Stroke RPGs RGs with less variation in age and Function Scores at admission will have fewer RPGs Groupings and naming conventions for the various RPG levels are presented in the Rehabilitation Patient Groups table which follows Inclusions exclusions RPG calculation requires completion of elements 8 Birth Date 34 RCG and 41 to 58 the FIM instrument on the admission assessment Interpretation considerations The RPG indicators in the NRS Comparative Reports and NRS Analytical Reports are designed to differentiate between groups of clients with the same rehabilitation diagnosis RCG and RG The RPG grouping method attempts to level the playing field by categorizing RGs and RCGs into homogeneous groups based on age and FIM instrument Motor and Cognitive scores at admission This grouping makes comparisons between peer groups somewhat more meaningful and may be used to support other findings in the comparative reports For example if a facility with a longer average length of stay LOS compared to its peer group is noted to admit a high proportion of stroke clients in the 1100 1110 and 1120 RPGs that is clients who use relatively more resources based on the RPG methodology this information may help to partially acco
139. l Quarter Loaded 2014 Q3 National Rehabilitation Reporting System NRS gt Shared Reports gt NRS Launch Page x The NRS eReports Launch Page is divided into four regions one that occupies the upper half of the page and three that occupy the lower half of the page as follows Top half displays some data that is of common interest to NRS facilities The user may alter which data is visible through use of an associated pull down menu and radio button Lower left contains a brief overview of the NRS and displays the date of the most recent data update Lower middle provides links to folders containing the three main types of reports available Quick Indicators Comparative Reports and Analytical Reports Lower right includes NRS eReporting reference documents as well as four links CIHI 2015 7 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Updates contains announcements regarding new features new reports service interruptions data uploads etc Support offers contact information for inquiries about the NRS eReporting information and products FAQs offers frequently asked questions and answers to those questions Education offers additional training help and NRS specific guidance The Launch Page also contains a navigation bar located at the top of the page which allows you quick access to a variety of NRS eReports folders and tools This nav
140. le metrics count percent Clients Achieving Service Goals Available in e NRS Comparative Reports gt Outcomes at Discharge gt 3 Clinical Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Follow Up This indicator reports on those clients at discharge who have met the rehabilitation goals set by the client and the rehabilitation team at the beginning of the rehabilitation stay It is reported as an overall number and as a percentage of all clients CIHI 2015 103 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Inclusions exclusions The indicator is calculated based on all discharge records with 31 Reason for Discharge coded as 1 or 2 Goals met and client discharged transferred Records with Admission Class 4 Un planned Discharge are not included in the percentage calculation of this indicator Interpretation considerations The team determines whether or not a client has met his or her rehabilitation goals at the time of discharge These goals are ideally developed at admission and are functional and measurable A client who has met the majority of the goals at the time of discharge can be considered to have met the goals Note that meeting rehabilitation goals does not necessarily imply a return to a client s pre injury level of function only that the client has progressed as anticipated by the team Available metric
141. lines April 2015 A client s recorded body weight at admission in kilograms kg Inclusions exclusions Weight metrics are only shown in NRS eReports for fiscal years 2009 2010 and later due to changes in NRS coding specifications put in place at that time Available metrics average mean median standard deviation minimum maximum 25 percentile 75 percentile 14 3 NRS Summary Functional Assessment Scores Definitions The summary functional assessment scores below are the basic score calculations for both the FIM instrument and CIHI Cognitive data elements Variations of these scores appear throughout the reports NOTE The functional assessment metrics found in the NRS eReports contain an A AD or ADF at the end of their names Metrics with an A are calculated from clients that have complete functional assessment scores on their admission records Metrics with AD are calculated from clients that have complete functional assessment scores at both admission and discharge ADF indicates metrics that have been calculated on clients having complete assessments at all of admission discharge and follow up records These letters have been added to the metric names to assist users in identifying the client population that is being used for each metric s calculation Total Function Score at Admission Available in e NRS Quick Indicators gt 2 Average Admission Total Function Score Acr
142. lines April 2015 NRS Data Quality Report for Provinces Territories A data quality report completed on an annual basis and sent to the deputy ministers of health of each province territory in an effort to raise awareness and highlight data quality issues O Original Methodology Case Mix Case Mix metrics may be found in Current Methodology or Original Methodology Comparative Reports or may be named as such in the Analytical Reports Current Methodology values are based on the current rehabilitation cost weights and outlier trim points being used in the RPG Case Mix Methodology visit www cihi ca casemix for more information on values that are currently being used Original Methodology values for a particular fiscal year are based on the rehabilitation cost weights and outlier trim points that were in effect during that fiscal year The Current Methodology values permit users to analyze trends over time whereas the Original Methodology values permit users to view the data that would have been seen in reports created in those fiscal years P Page By Axis The page by axis appears at the top of each report grid or graph and provides you with a way to change which information is displayed in the report Using this axis you can restrict visible grid or graph data according to a specific attribute or metric The page by axis may automatically include metrics and attributes that are available in the report
143. logy Outlier Days may be attributed to only one client or represent the sum of outlier days from many clients within an RPG Outlier Cases Long Stay Rehab Cost Weight AVG The average rehabilitation cost weight for lengths of stay that exceeded the trim point that defines long stay outliers for a particular RPG as defined by CIHI s RPG Case Mix Methodology Outlier Cases Short Stay Clients COUNT The number of clients that had individual lengths of stay less than or equal to the short stay trim point for a particular RPG and therefore are considered short stay outliers as described by CIHI s RPG Case Mix Methodology Outlier Cases Short Stay Days COUNT The total number of days accrued for lengths of stay that were less than or equal to the short stay trim point for a particular RPG as described by CIHI s RPG Case Mix Methodology Outlier days may be attributed to only one client or may represent the sum of outlier days from many clients within an RPG CIHI 2015 102 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Outlier Cases Short Stay Rehab Cost Weight AVG The average rehabilitation cost weight for lengths of stay less than or equal to the short stay trim point for a particular RPG as described by CIHI s RPG Case Mix Methodology Weighted Cases COUNT Calculated as the average cost weight multiplied by the number of complete episodes An episode is considered as co
144. lso find more about these terms in Appendix B NRS Glossary 5 1 Report A report is the outcome of analytical queries The knowledge gained from reports can be used in decision support activities A report is created by querying a CIHI data mart containing Canadian health data such as the National Rehabilitation Reporting System Reports can be formatted in three ways 1 Grid report data is displayed in a table 2 Graph report data is displayed on a graph 3 Grid and graph report data is displayed in both a data table and on a graph You can switch between these three formats by using the Home drop down menu or the appropriate toolbar buttons The formatting options that are available to you in each of these formats are different and the visible toolbars and menu items will automatically update as you switch between them 5 2 Prompts Prompts are used to dynamically modify the content of a report at run time When creating a report you will be prompted for information that will tell the application what kind of report to produce and which data to include For example you might be prompted to select a particular outcome to look at or a time period on which to focus for example Fiscal Year 2010 2011 or to select the facilities with which you want to compare your own 5 3 Attributes Attributes allow for the presentation of data by categories They are added to reports to allow data to be summarized at varying levels of det
145. mes at Discharge OF Outcomes at Follow Up RU Resource Utilization Report numbers are shown for Quick Indicators and Comparative Reports cont d NRS Quick NRS Comparative NRS Analytical Indicators Reports Reports Case Mix Metrics Case Mix Clients COUNT RU 3 4 RU 1 2 Case Mix Index AVG RU 3 4 Case Mix Length of Stay COUNT RU 3 4 RU 1 2 Cost Weight AVG RU 3 4 RU 1 2 Non outlier Cases Days COUNT RU 3 4 RU 1 2 Non outlier Cases Rehab Cost Weight AVG RU 3 4 RU 1 2 Outlier Cases Long Stay Clients COUNT RU 1 2 Outlier Cases Long Stay Days COUNT RU 3 4 RU 1 2 ae Cases Long Stay Rehab Cost Weight RU 3 4 RU 1 2 Outlier Cases Short Stay Clients COUNT RU 1 2 Outlier Cases Short Stay Days COUNT RU 3 4 RU 1 2 ea i Short Stay Rehabilitation Cost RU 3 4 RU 1 2 Weighted Cases COUNT RU 3 4 RU 1 2 Clients Achieving Partial or Full Community Reintegration RNLI Count OF 5 Percent OF 5 Clients Achieving Service Goals Count OD3 OD OF Percent OD 3 OD OF Clients Admitted Count AP 1 6 AP Percent AP 1 6 AP Clients Discharged Count OD 1 0D 4 OD Percent OD 4 OD Clients Discharged Home Who Were Home Prior to Admission Count OD Percent QI 8 OD CIHI 2015 89 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Table 14 1 Availability of metrics across NRS eRep
146. mes at Discharge gt 3 Clinical Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Discharge CIHI 2015 106 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 The number and percentage of clients reporting improved 70 General Health Status on the discharge assessment compared to the admission assessment This is one of the outcome indicators in the NRS and is based on a client report data element This data element was derived from the 1996 National Population Health Survey developed by Statistics Canada An example of improved health status would be a client who had reported his or her health status as Poor on admission reporting it to be Good at discharge This indicator requires completion of data element 70 on both the admission and the discharge assessments Inclusions exclusions The N value excludes records with a response code of 8 Unable to assess on element 70 for either the admission or discharge assessment The denominator for the percentage calculation includes all discharge records Interpretation considerations This indicator describes only those clients reporting an improvement in health status over the course of the rehabilitation stay The balance of the percentage value represents clients who reported either no change in health status or a worsening of health status from admission to discharge or were unable to be assessed for that element Additionally the General Health St
147. mns you want to see This is achieved using the Filter on Selections feature that is available via the Data menu and toolbar or via the menu that appears after right clicking on a particular row or column This feature will allow you to keep certain rows or columns of data while filtering out others but has less flexibility than a View Filter CIHI 2015 46 v NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 8 Saving Exporting and Printing 8 1 How to Save a Report A report can be saved by selecting the Save icon on the Home toolbar or from the Home drop down menu This feature will allow you to save your report in the My Reports folder that is available in NRS eReports This feature is useful if you want to customize the content and format of your reports and then save them to be rerun every quarter Reports saved in this folder can then be refreshed every quarter with new data see text box below When you select the Save option the My Reports window will open If you have previously saved any reports in this folder you will see them listed here A default name and description of the report you are trying to save also appears You may wish to re name the report and use a description that will make the report and its contents easy to identify Important You can save reports to My Reports so that they can be manually refreshed with new data every quarter For example you may wish to view an upda
148. mplete when both the admission and discharge records have been received by CIHI and the discharge date falls in the current reporting quarter Clients Achieving Partial or Full Community Reintegration RNLI Available in e NRS Comparative Reports gt Outcomes at Follow Up gt 5 Clients Achieving Partial or Full Community Reintegration The Reintegration to Normal Living Index RNLI measures a client s perception of his or her post rehabilitation capabilities in terms of self care work social activities and relationships etc This indicator calculates the number and percentage of clients who scored either 1 Partial Integration or 2 Full Integration on follow up for each RNLI domain Move around living quarters Move around community Take trips out of town Comfortable with how self care needs are met Spend most days occupied in work activity Able to participate in recreational activities Participate in social activities Assume a role in family which meets self and family needs Comfortable with personal relationships Comfortable with self in the company of others Can deal with life events as they happen VVVVV VV VV VV Inclusions exclusions Requires completion of all RNLI domains on the follow up assessment Results are reported at the facility peer and national levels Interpretation considerations The scoring scale for this tool was adapted with permission from the original tool developed by S Wood Dauphinee Availab
149. n a freestanding hospital but can be a specialized unit within a larger acute or chronic care facility In addition to interventions provided in a General Rehabilitation Facility clients in a Specialty Facility also have access to more comprehensive services such as surgical specialists orthotics prosthetics etc Sphincter Domain FIM instrument Includes the FIM instrument motor items that assess sphincter control Bladder Management Bowel Management CIHI 2015 144 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 T Toileting FIM instrument Includes three main tasks 1 adjusting clothing before using toilet commode or bedpan 2 maintaining perineal hygiene and 3 adjusting clothing after using toilet commode or bedpan Total Function Score FIM instrument The sum of the scores for all 18 elements on the FIM instrument ranging from 18 to 126 A higher Total Function Score suggests a higher level of independent functioning in activities of daily living and communication Transfer Domain FIM instrument Includes the FIM instrument motor items that assess ability to transfer from one surface to another Bed to Chair Wheelchair Transfer Toilet Transfer and Tub Shower Transfer Transfers Bed Chair Wheelchair FIM instrument Includes all aspects of transferring to and from a bed chair and wheelchair if client uses a wheelchair or coming to or from a standi
150. n specialized rehabilitation hospitals and in general hospitals within rehabilitation units programs or designated rehabilitation beds As of 2011 2012 there were over 330 000 pairs of admission and discharge records that is complete episodes in the NRS database submitted by over 100 hospitals in nine provinces and covering a range of health conditions including strokes orthopedic conditions and amputations The introduction of NRS data to the Portal environment provides users with access to data surrounding adult inpatient rehabilitation services The NRS data set consists of data elements of the following major categories e Socio Demographics Information such as full date of birth sex living arrangements and vocational status are collected to provide valuable information on the types of patients admitted to rehabilitation programs e Administrative Data is collected on wait times for admission and discharge service interruptions and provider types in order to better understand accessibility to rehabilitation factors influencing length of stay and resource utilization e Health Characteristics Diagnoses and related comorbidities at admission provide information on conditions most often seen in a rehabilitation setting and conditions that may affect a patient s ability to progress in the rehabilitation program e Activities and Participation This is the largest section of the data set and provides clinical data on the motor and c
151. nctional status at time of admission and time of discharge as well as the change between them are included in this report 3 Clinical Outcomes at Discharge View clinical outcome indicators for clients discharged during the defined reporting period Indicators include counts and percentages of clients reporting improvements in health status improvements worsening of pain and clients achieving service goals 4 Discharge Destination View discharge counts and percentages by discharge destination for the defined reporting period 5 Length of Stay and Service Interruptions View length of stay and service interruption information for clients discharged during the defined reporting period Indicators include average onset days service interruption days days waiting for admission and discharge length of stay excluding interruption days active rehab length of stay length of stay efficiency and active rehab length of stay efficiency 11 5 Outcomes at Follow Up Comparative Reports The following section describes the contents of the Outcomes at Follow Up sub folder This folder contains five reports These reports provide summary socio demographic and client CIHI 2015 65 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 function data for the 80 to 180 day period following discharge from a rehabilitation facility into the community can include clients discharged to long term care Completion of the follo
152. nd er the last 5 fiscal years Peer groups are based upon General Speciatty facilty types 09 Average Follow up Total Function Score Across Rehabilitation Client Groups RCGs O ch Rehabilitation Client Group at the Facility Peer and ups are based upon General Specialty facility types 02 Average Admission Total Function Score Across Rehabilitation Client Groups RCGs 42 AM Total Function Score for each Rehabilitation Client Group at the Facility Peer and the last 5 fiscal years Peer groups are based upon General Specialty facility types 04 Average Change in Total Function Score Across Rehabilitation Client Groups RCGs Owner Administrator ified 6 25 10 10 27 42 AM Total Function Score for each Rehabiltation Client Group at the Facility Peer and the last 5 fiscal years Peer groups are based upon General Specialty facility types 06 Average Length of Stay LOS Across Rehabilitation Client Groups RCGs Owner Administrator Client Group at the Facility Peer and National jon General Specialty facility types Export PDF 08 Percent Discharged Home Who Were Home Prior to Admission Across Rehabilitation Client Groups RCGs med home after discharge for each Rehabilitation Client Group at the e last 5 fiscal years Peer groups are based upon General Speciatty Export PDF 10 Data Quality Indicators Report Owner Administra or Modified 8 30 12 10 09 20 AM indicators at
153. nd national levels Note that this indicator can only be calculated for clients that have complete admission and discharge Total Function Scores 5 Average Days Waiting for Discharge Across Rehabilitation Client Groups RCGs This graph formatted report illustrates the average days waiting for discharge for each RCG at the facility peer and national levels CIHI 2015 57 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 6 Average Length of Stay LOS Across Rehabilitation Client Groups RCGs This graph formatted report illustrates the average LOS for each RCG at the facility peer and national levels 7 Average Length of Stay LOS Efficiency Across Rehabilitation Client Groups RCGs This graph formatted report illustrates the average LOS efficiency for each RCG at the facility peer and national levels Note that this indicator can only be calculated for clients that have complete admission and discharge Total Function Scores 8 Percent Discharged Home Who Were Home Prior to Admission Across Rehabilitation Client Groups RCGs This graph formatted report illustrates the percent of clients discharged home who were home prior to admission for each RCG at the facility peer and national levels 9 Average Follow Up Total Function Score Across Rehabilitation Client Groups RCGs This graph formatted report illustrates the average follow up Total Function Score for each RCG at the facility peer
154. ng 2 Other community Post Discharge Living Setting 3 4 6 7 Residential Care Post Discharge Living Setting 5 Acute care Post Discharge Living Setting 9 or Referred To 02 03 Expired Reason for Discharge 8 Inclusions exclusions Response codes 50 Not available and 70 Unknown for elements 15 and 32 are included in the denominator for percentage calculations Facility Available in e All NRS eReports A unique name and five digit identifier used by an organization to submit data to the NRS An NRS facility may represent gt An entire organization that provides rehabilitation such as a residential care facility nursing home or gt A unit or number of beds designated for rehabilitation within a larger organization such as a complex rehabilitation unit The name is based on the official name of the organization as listed in CIHI s Organization Index and may not exactly match the facility and site names as submitted in the NRS Facility Profile record CIHI 2015 75 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Facility Program Type Available in e All NRS Analytical Reports The type of program as defined by the rehabilitation facility unit Facility Type Available in e All NRS eReports Describes the facility as general or specialty based on facility self assessment of the nature of the services the type of hospital the service is located in the provincial
155. ng rinsing and drying the body from the neck down excluding the neck and back may be either a tub shower or sponge bed bath Bladder Management FIM instrument Includes intentional control of the urinary bladder and if necessary use of equipment or agents for bladder control The functional goal of bladder management is to open the urinary sphincter only when it is needed and to keep it closed the rest of the time This may require devices drugs or assistance in some individuals Body Mass Index BMI A weight to height ratio score calculated by dividing the client s body weight in kilograms by the squared value of the client s height in metres that is kg m BMI values are grouped into four standard categories underweight lt 18 5 normal 18 5 24 9 overweight 25 30 and obese gt 30 A fifth category unable to calculate is used in the NRS eReports to capture clients for whom a BMI could not be calculated because of a missing height element 40A or weight element 40B value for instance CIHI 2015 137 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Bowel Management FIM instrument Includes intentional control of bowel movements and if necessary use of equipment or agents for bowel control The functional goal of bowel management is to open the anal sphincter only when it is needed and to keep it closed the rest of the time C Cognitive Function Score FI
156. ng of peer groups NRS eReports folder May 2010 CR OD 5 CR RU 5 AR OD AR OF AR June 2010 RU 1 amp 2 Added Active Rehab Length of Stay Efficiency metrics to various reports Added Active Rehab Length of Stay Mean metric to CR RU 5 Added Clients Discharged Home that Were Home Prior to Admission Count and AR OD June 2010 Percent metrics Added all Case Mix related metrics for both Current and Original methodologies except Case Mix Index metric previously found in the CR RU 3 amp 4 reports to the AR RU 1 amp 2 reports Additionally added new metrics Outlier Cases Short Stay Count of Clients and Outlier Cases Long Stay Count of Clients Added ability to drill from Fiscal Year to Fiscal Quarter for Quick Indicator reports QI 1 9 June 2010 except QI 10 Changed methodology slightly for QI 2 4 to include only clients that have Total Function Score at both Admission and Discharge Previously these reports included any client having Total Function Score at Discharge QI 2 4 June 2010 with or without an equivalent Admission score Change affected only one client in database but done to improve the reports logic CR RU 5 June 2010 AR RU 1 amp 2 June 2010 CIHI 2015 146 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Modification Location Implementation Date Changed method
157. ng position if walking is the typical mode of locomotion Client moves from a supine to a standing position on the bed and vice versa Transfers Toilet FIM instrument Includes getting on and off a toilet Transfers Tub or Shower FIM instrument Includes getting into and out of a tub or shower stall Includes positioning standing pivot sitting or sliding transfer and for tub transfers also includes lifting legs over threshold of tub U Un planned Discharge One of the available options for coding Admission Class in the NRS Refers to an inpatient rehabilitation stay lasting three days or less including the day of admission Includes planned and unplanned discharges In these cases the Admission FIM instrument is typically not completed but can be included in the NRS record if complete V N x Xx S amp S CIHI 2015 145 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Appendix C History of Changes to the NRS eReports The following table lists the modifications that have been made to the NRS eReports since the system was launched in July 2009 Questions about any of these modifications can be directed to nrs cihi ca Implementation Date Modification Location MicroStrategy Version 9 implemented Includes improved functionality and minor Throughout Jan 2010 changes to appearance Created two Peer Information RCG reports to assist with picki
158. nine graphs have identical properties each reporting on a different indicator The 10th report displays a grid containing four data quality indicators Reports are organized to present information at the facility peer and national levels Peer groups are based on Facility Type General or Specialty Users are prompted only for Facility Name Number in order to generate the report Data can be shown for any of the most recent six fiscal years or partial years The first nine reports also permit drilling from fiscal year to fiscal quarter Each Quick Indicator report is briefly described below 1 Average Days Waiting for Admission Across Rehabilitation Client Groups RCGs This graph formatted report illustrates the average days waiting for admission by RCG at the facility peer and national levels 2 Average Admission Total Function Score Across Rehabilitation Client Groups RCGs This graph formatted report illustrates the average admission Total Function Score for each RCG at the facility peer and national levels 3 Average Discharge Total Function Score Across Rehabilitation Client Groups RCGs This graph formatted report illustrates the average discharge Total Function Score for each RCG at the facility peer and national levels 4 Average Change in Total Function Score Across Rehabilitation Client Groups RCGs This graph formatted report illustrates the percent change in Total Function Score for each RCG at the facility peer a
159. nknown Date Ready for Admission This indicator identifies the percentage of admission records with data element Date Ready for Admission coded as unknown as calculated below A B 100 expressed as a percentage where A The number of admission records for clients admitted in the reporting period with Date Ready for Admission element 20A coded as Unknown B The total number of admission records excluding unplanned discharges for the reporting period by facility Interpretation considerations In the NRS this data element is used to assess the time a person waits between the determination that they are suitable and ready for inpatient rehabilitation and their actual admission This information can be used to monitor admission patterns and referral processes Since Date Ready for Admission is used to calculate the Days Waiting for Admission indicator for various NRS reports participating facilities are encouraged by CIHI to collect the data element whenever possible NRS records with this data element coded as unknown are excluded from calculation of the Date Ready for Admission indicator Available metrics count percent Days Waiting for Admission Available in e NRS Quick Indicators gt 1 Average Days Waiting for Admission Across RCGs e NRS Comparative Reports gt Outcomes at Discharge gt 5 Length of Stay and Service Interruptions e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt
160. no rehabilitation was received for the RCG Un planned Discharge 19A 4 includes episodes for which the length of stay is three days or less including the admission date This group may also include planned discharges in three days or less For clients coded as Un planned Discharge no corresponding discharge record is submitted to the NRS ASIA Impairment Scale Available in e NRS Analytical Reports gt Admissions Profile Describes the distribution of clients in the various ASIA impairment scale categories based on the response coded for element 38 ASIA Impairment Modified Frankel Scale ASIA Impairment Scale describes the degree of motor and sensory involvement at admission to rehabilitation for traumatic and non traumatic spinal cord injury Legend 1 A Complete impairment 2 B Incomplete sensory preserved 3 C Incomplete motor non functional 4 D Incomplete motor functional 5 E Normal CIHI 2015 73 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Body Mass Index BMI Group at Admission Available in e All NRS Analytical Reports Describes the distribution of clients based on their calculated Body Mass Index BMI value on admission BMI is calculated by dividing the client s admission body weight in kilograms by the squared value of the client s height in metres that is kg m BMI values are grouped into four s
161. o other NRS indicators change in Total Function Score and LOS both of which can be influenced by multiple factors Care should be exercised when comparing this indicator to results from other facilities Available metrics average mean median standard deviation minimum maximum Onset Days Available in e NRS Comparative Reports gt Outcomes at Discharge gt 5 Length of Stay and Service Interruptions e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Follow Up The number of days from element 39 Date of Onset to element 21 Admission Date This indicator describes the average length of time in days between the onset of or the exacerbation of the rehabilitation condition and the date of entry into the rehabilitation program Inclusions exclusions Records where the Date of Onset is left blank are excluded this item is not mandatory to code if 19A Admission Class 4 Un planned Discharge Interpretation considerations Large differences between the average value and the median value for Onset Days may be due to the presence of very high values in the data set Date of Onset for chronic conditions is sometimes erroneously coded as the date that the condition was first diagnosed rather than the date of the most recent exacerbation For example if a client was admitted to rehabilitation on December 30 2010 for treatment of an exacerbation
162. oded only when the client misses more than one day of active rehabilitation and the condition is felt to impact the client s progress in rehabilitation This does not include weekend passes to visit family at home or temporary bed closures Available metrics count Data Quality Indicators Available in e NRS Quick Indicators gt 10 Data Quality Indicators Report Four data quality indicators are provided in this grid formatted report Columns indicating facility peer and national values are provided The indicators are expressed as both the number of records used in the calculation N and as percentages The four indicators are a subset of the indicators in the NRS Data Quality Report for Provinces Territories which is completed on an annual basis and sent to the deputy ministers of health of each province and territory in an effort to raise awareness and highlight data quality issues If the report does not show data for one or more of these indicators it is because the facility does not have any data to show for that fiscal period The four data quality indicators are described below Unknown Referred to Facility Number This indicator identifies the number of episodes where Referred to Facility Number is coded as Unknown as calculated below A B 100 expressed as a percentage where A The sum of episodes with 99999 Unknown coded for data element Referred to Facility Number by facility B The total number of episodes
163. of the report The message Executing SQL means that the report is still executing and is not yet available for viewing Message Creation Time The Message Creation Time column indicates the last date and time the History List report information was updated The time displays as Eastern Time unless you have indicated another time zone in the NRS eReports Preferences area see Section 4 4 Remove CIHI 2015 11 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 The Remove column allows you to remove reports from your History List Select the check box for the report you want to remove and click the Remove column heading You should routinely remove reports that you no longer need to access instantly in order to free up server space Additionally each report is listed with the following four icons Export The Export icon gives you one click access to export the report in your choice of formats Click on the icon to begin the export process PDF The PDF icon gives you one click access to generate a PDF version of the report Click on the icon to begin the PDF creation process Details The Details icon that is the blue circle with an i in it opens a new page that provides you with additional details about that report Rename The Rename icon allows you to change the name of that particular report in the History List How to use the History List 1 Navigate to the History List
164. ogin button 4 The eReporting Terms and Conditions page will appear Please review the terms of the agreement You must click on I Agree to proceed 5 You will now see the eReporting Gateway Page Projects Page This page provides links to all of the different eReporting databases to which you have access MIS CCRS NACRS etc If you only have access to NRS eReporting then this is the only link that you will see Figure 2 1 The eReporting Gateway Page User with access to the National Rehabilitation Reporting System only Welcome Guest If you are not Guest _click here National Rehabilitation Reporting System NRS The National Rehabilitation Reporting System NRS contains client data collected from participating inpatient rehabilitation facilities and programs across Canada VER 1 0 Please Click a Province or Territory to visit their Ministry of Health Ontario Ministry of Health and Long Term Care 6 Click the National Rehabilitation Reporting System NRS link to continue 7 You will be directed to the NRS eReports Launch Page which is described in the next chapter CIHI 2015 6 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 3 NRS eReports Launch Page 3 1 Overview The first page that you encounter once you have successfully logged in to CIHI eReports system and selected the NRS eReports is called the Launch Page Figure 3 1 Figure 3 1 Ex
165. ognitive functional abilities of rehabilitation patients The data is collected using the 18 item FIM instrument and six additional cognitive data elements developed at CIHI Together these provide further information on the cognitive abilities of rehabilitation patients The NRS data elements are presented in the Portal environment in the following format NRS Common Attributes NRS Diagnosis Analysis NRS Interruption Analysis NRS Episode Analysis go Go ie CIHI 2015 150 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 5 NRS Procedure Analysis Analytical Objects Attributes Metrics Most NRS attributes and metrics that are available in the Portal environment are described in Chapters 13 amp 14 of this NRS eReports Manual For a complete list of NRS attributes and metrics available in Portal s ad hoc environment including object name description and location in the Portal environment please consult the NRS Data Dictionary available on the Portal client services site NRS eReports In addition to providing the ability to create ad hoc reports with NRS data CIHI Portal also permits access to most or all of the existing NRS eReports as described in this NRS eReports Manual depending on the level of access possessed by a particular user NRS Quick Indicators Quick Indicators are the quickest and simplest type of reports to generate They are nine at a glance reports of seve
166. ology Case Mix report CR RU 3 amp 4 AR RU 1 amp 2 Sept 2010 Changed methodology slightly based on discussions with Case Mix group for assignment of RPGs 2700 Burns and 3000 Ventilator Dependent Respiratory Disorders These two RPGs are now assigned to any clients with RCG 11 1 or 17 51 respectively regardless of whether or not they have complete admission FIM scores For all other RPGs only clients with complete admission FIM scores will be considered for classification all others will be assigned to the Not Applicable category Throughout Sept 2010 Launched NRS Portal ad hoc reporting environment available to clients subscribing to CIHI Portal product NRS eReports included in Portal environment N A Jan 2011 CIHI 2015 147 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Modification Location Moved all reports from Shared Reports folder to NRS eReports folder Shared Reports Implementation Date Jan 2011 Changed naming format of all metrics For example Onset Days Mean changed to Onset Days AVG and Clients Discharged Count changed to Clients Discharged COUNT Throughout Jan 2011 Changed naming convention for functional assessment metrics Each such metric now has A AD or ADF included in its name to identify the client populat
167. ology slightly for CR RU 5 to filter out clients that do not have a complete Total Function Score at Discharge Also changed metric displayed in the first column of the report from Clients Discharged Count to Clients with a Complete Discharge FIM Instrument Assessment Count as this is the population on which the remaining metrics are based CR RU 5 June 2010 Added Rehabilitation Patient Group RPG and Rehabilitation Group RG attributes to the prompt screens of all Analytical Reports previously only available for AR RU reports AR AP AR OD AR OF July 2010 Added Clients Reporting Worsening of Pain Count and Percent metrics CR OD 3 AR OD AR OF Sept 2010 Added Weight and Body Mass Index BMI metrics Only calculated for fiscal years 2009 2010 and later due to changes in database specifications CR OD 1 AR AP AR OD AR OF AR RU Sept 2010 Added Body Mass Index BMI as an attribute Composed of the four standard BMI groupings plus Not Able to Calculate Only calculated for fiscal years 2009 2010 and later due to database changes AR AP AR OD AR OF AR RU Sept 2010 Added the latest 2010 2011 MOH LTC Cost Weight values weights amp trim points to the eReports These values will be applied to all fiscal years in any Current Methodology Case Mix report but only to 2010 2011 data in any Original Method
168. on records include a data element to indicate if a client s birth date has been estimated 9 Birth Date Estimated Since all NRS admission records are included in the calculation of age indicators the accuracy of the values provided may vary depending on the number of records submitted for which the date of birth has been estimated Additionally the methodology for calculation of age rounds down to conform to the methodologies used in other CIHI databases Admission Class Available in e NRS Comparative Reports gt Admissions Profile gt 3 Admission by Admission Class e NRS Analytical Reports gt Admissions Profile Describes the distribution of clients in the various admission categories based on response coded for element 19 Admission Class Initial Rehabilitation 19A 1 refers to the first rehabilitation admission to a rehabilitation facility or unit for the specific RCG Continuing Rehabilitation 19A 5 refers to clients who are transferred directly from another rehabilitation facility or from a different level of rehabilitation within the same facility for the same RCG Short Stay 19A 2 refers to a pre planned rehabilitation stay of 4 to 10 days or unexpected discharges within the same time frame Readmission 19A 3 occurs when the client has already received rehabilitation for the specific RCG at some point in the past and has been readmitted for the same RCG directly from the community or another facility where
169. ondition ICD 10 CA Available in e NRS Analytical Reports gt Outcomes at Discharge CIHI 2015 114 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Health conditions that arise after admission and during the rehabilitation stay that affect the client s health functional status and resource requirements during the rehabilitation program This includes post admit complications and or comorbid conditions that delay interrupt or compromise the effectiveness of the rehabilitation program or represent high medical risk disorders e g previous cardiac arrest pulmonary embolus ruptured aneurysm Includes conditions of short duration that were resolved during the stay and conditions that persist at discharge The number of Post Admit Comorbid Health Conditions coded at discharge from inpatient rehabilitation A total of 15 Post Admit Comorbid Health Conditions can be coded at discharge for each client Inclusions exclusions Post Admit Comorbid Health Conditions are only mandatory to record if a health condition s arises after admission and during the rehabilitation stay that affects the client s health functional status and resource requirements during the rehabilitation program Interpretation considerations This indicator reflects Comorbid Health Conditions that arose during the patient s rehabilitation stay There is a potential data quality issue surrounding inaccurate coding of existing comorbiditi
170. one or more choices of facility name number b Fiscal Year s allows one or more fiscal years for which to view data c Rehabilitation Client Group s allows selection of one or more RCGs of interest if no selection is made reports will be generated for all RCGs by default d Metrics allows selection of one or more metrics that you would like displayed on your report choice of metrics will depend on which Analytical Report is being created e Attributes allows selection of one or more attributes that you would like displayed on your report choice of attributes will depend on which Analytical Report is being created 5 Once you have made selections for all of the necessary prompts click Run Report in the bottom left hand corner A Wait Page will appear while your report is being created see Section 6 6 for more information on the Wait Page This page appears because the reports are created on demand based on information you have asked for Report creation may take several seconds or up to one minute depending on the report that you chose to generate 6 Once the report has been created you will see the Report screen The Report screen with all of its menus and toolbars will allow you to modify how the data is displayed Chapter 7 provides more information about how to modify your report using the tools provided on the Report screen For instance you might a Drill into one or more of the attributes and metrics b Alter the Pag
171. only those that affect the client s health functional status and resource requirements during the rehabilitation program Chronic or other conditions that do not meet these criteria may be inappropriately captured this may lead to over coding of some conditions Conversely comorbidities may not always be coded as often as they should for a variety of reasons Care should be exercised when comparing this indicator between facilities jurisdictions Available metrics count CIHI 2015 115 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Sex Available in e NRS Comparative Reports gt Outcomes at Discharge gt 1 Client Demographics Describes the percentage of total clients discharged that are male and the percentage that are female Denominator used for the percentage calculation includes clients who have identified as Other where applicable Available metrics percent Total Service Interruptions Available in e NRS Comparative Reports gt Outcomes at Discharge gt 1 Client Demographics e NRS Analytical Reports gt Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Follow Up The total number of service interruptions experienced by clients at the facility in the given reporting period Occur when a client is unable to participate in the rehabilitation program due to a health condition that may or may not result in a transfer out of the rehabilitation bed or unit Service in
172. ons Profile CIHI 2015 79 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Describes the distribution of clients admitted from various living environments based on the response choice for data element 14 Pre Hospital Living Setting The response choices for this data element are clinicians must code one option only 1 Home private house or apartment without health services 2 Home private house or apartment with paid health services formal or informal private or publicly funded Boarding house includes rented room Assisted living includes group home retirement home supervised living setting Residential care long term care facility convalescent care nursing home Public place includes residing in the street parks and other public spaces Other 50 Not available temporarily 70 Asked unknown 3 4 5 6 Shelter includes night shelter refuges hostels for homeless 7 8 For reporting purposes the response choices have been grouped as follows Home private without services code 1 Home private with services code 2 Boarding house code 3 Assisted living code 4 Residential care code 5 Shelter code 6 Public place code 7 Other code 8 Inclusions exclusions Response codes 50 Not available and 70 Unknown are included in the denominator for percentage calculations Interpretation considerations This indicator along with Admission by Pre Hosp
173. ormities 13 Other Disabling Impairments 14 Major Multiple Trauma 15 Developmental Disabilities 16 Debility 17 Medically Complex Rehabilitation Group Available in e NRS Comparative Reports gt Resource Utilization Reports e All NRS Analytical Reports A type of categorization representing the highest level of diagnostic classification for clinically similar patients and used in the RPG case mix grouping methodology for the NRS Rehabilitation Patient Group Available in e NRS Comparative Reports gt Resource Utilization Reports e All NRS Analytical Reports The NRS now includes a case mix grouping methodology known as the Rehabilitation Patient Group RPG methodology This methodology was developed by the Rehabilitation Technical Working Group of Ontario s Joint Policy and Planning Committee JPPC using NRS data for Ontario facilities The JPPC a joint partnership of the Ontario Hospital Association and the Ontario Ministry of Health and Long Term Care MOHLTC released a summary report based on Ontario data titled Evaluation and Selection of a Grouper and Weighting Methodology for Adult Inpatient Rehabilitation Care in October 2006 The RPGs have cost weights associated with them and explain variance in length of stay and other NRS variables of interest to a greater extent than the FIM FRGs and other methodologies based on the FIM instrument They represent a natural transition to a Canadian grouping methodology for inpatien
174. ort to analyze Admission Profile Outcomes at Discharge Outcomes at Follow up and Resource Utilization for the last 5 fiscal years Customize your report by choosing what indicators to include and how to display your report Peer RCG Information Report Owner Administrator Modified 11 26 10 12 28 25 AM View up to date and historical information regarding facility type bed numbers facility location and discharges a by RCG for all facilities submitting data to the NRS This information can be used to aid users in the selection of es appropriate peers Export PDF 2 NRS Comparative Reports Owner Administrator Modified 12 15 10 2 17 20 PM View a comprehensive set of NRS indicators at the Facility Peer and National Is for the last 5 fiscal years Users can select options for various factors including peer group RCG and reporting period Reports can be viewed as tables or graphs Peer Information Report for Facilities Submitting Follow up Data Owner Administrator Modified 2 14 11 1 25 59 AM View up to date and historical information regarding facility type bed numbers and facility location for all facilities submitting follow up data to the NRS This information can be used to aid users in the selection of appropriate peers Export PDF 2 The Quick Indicators folder displays 10 report icons 9 reports in graph form and 1 in grid form Each icon includes the name and a brief description of the report to
175. orting The indicator is calculated based on Presence of Pain 59A and based on the Pain Score the sum of the scores from data elements 59B Intensity of Pain Discomfort and 59C Activity Limitation Due to Pain Discomfort The Pain Score ranges from 4 to 9 where 4 is severe pain with most activities restricted and 9 is mild pain with no activity restrictions This indicator is calculated using all records where Presence of Pain 59A yes on discharge and or where the Pain Score has decreased from admission to discharge i e larger number on admission than on discharge Inclusions exclusions Records are excluded where 59A Client Unable to Answer on the admission and or discharge assessment Interpretation considerations This indicator describes only those clients having pain on discharge that did not have pain on admission or those showing a decrease in Pain Score over the course of the rehabilitation stay Note that a higher Pain Score in this case represents less overall pain and or fewer activities restricted by pain The balance of the percentage value represents clients who showed either no change in Pain Score or an increase in Pain Score from admission to discharge or were unable to be assessed for that element Additionally element 59 Impact of Pain is based on the client s perception of the overall pain level rather than a measured observation and therefore has a qualitative nature Available metrics count percent Cl
176. orts Report sub types are abbreviated as follows AP Admissions Profile OD Outcomes at Discharge OF Outcomes at Follow Up RU Resource Utilization Report numbers are shown for Quick Indicators and Comparative Reports cont d Clients Followed Up NRS Quick Indicators NRS Comparative Reports NRS Analytical Reports Count OF 1 2 OF Percent OF 1 2 OF Clients Home Prior to Admission Count OD Clients Hospitalized Since Discharge Count OF 3 OF Percent OF 3 OF Clients Maintaining Function Score Gain Count OF 3 OF Percent OF 3 OF Clients Maintaining General Health Status Count OF 3 OF Percent OF 3 OF Clients Reporting Improved Health Status Count OD 3 OD Percent OD 3 OD Clients Reporting Improvement in Pain Count OD 3 OD Percent OD3 OD Clients Reporting Worsening of Pain Count OD 3 OD Percent OD 3 OD Clients With a Complete Admission and Discharge CIHI Cognitive Instrument Assessment Count OD 1 OD Clients With a Complete Discharge FIM Instrument Assessment Count OD1 RU5 OD RU Clients With Service Interruptions Count OD 1 OD Data Quality Indicators Unknown Referred to Facility Number QI 10 Unknown Health Care Number QI 10 Unknown Date Ready for Admission QI 10 CIHI 2015 90 NRS eReports Manual User Guide and Report Interpret
177. orts etary ONO TEO ii PEE UIN are mAT e 4 12 Action Toolbar When viewing the contents of a folder for instance Shared Reports folder or My Reports folder you will see a small toolbar to the left just beneath the trail of breadcrumbs toolbar see Figure 4 7 Figure 4 7 The Action Toolbar m ma a Icons from left to right New Folder Create a new folder within the present location Tree view Display navigation tree Details Display contents descriptions Icon view Display folder contents in icon view Refresh Refresh the folder contents The actions available in this toolbar will vary depending on what is being viewed in the main section of the screen See Section 7 2 Toolbar for other actions that may be available in eReports Below the Action Toolbar the user can navigate using the tree structure The tree structure allows you to retain the folder structure in a panel on the left hand side of your screen while viewing the folder contents in a panel on the right This may assist you in gaining a better understanding of the folder structure and in reducing the amount of time required to find a particular report CIHI 2015 15 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 5 NRS eReports Terminology This chapter contains some terms to review before you begin creating reports It may help to refer back to these terms when you start to look at a few reports You can a
178. ospital Garden Street Site ON 54647 Bruy re Continuing Care Elisabeth Bruy re Hospital ON 53782 e Cambridge Memorial Hospital ON 54720 Fo N E SE Ye nT meee T Selected m gt Ee Be none CIHI 2015 24 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 5 When the Selected box contains the desired Facility press the Run Report button located in the lower left hand corner While your Quick Indicator report is being created you will see a Wait Page that provides you with some clickable options See Section 6 6 for more information about the Wait Page 6 Once the report has been created you will see the Report screen The Report screen with all of its menus and toolbars will allow you to modify how the data is displayed Chapter 7 provides more information about how to modify your report using the tools provided on the Report screen but briefly a From the Page By boxes at the top of the report you can select which fiscal year s you want to focus on By default the most recent fiscal year is shown However you may wish to include older data in your report b Results shown for the Peer comparison are based on the facility type either General or Specialty which corresponds to the displayed facility These values are averages calculated from all NRS submitting facilities that designate themselves as that particular facility type c Averages sh
179. ospitalization Since Discharge 1 Yes out of the total number of follow up assessments reported Inclusions exclusions Response codes 50 Not available and 70 Unknown are included in the denominator for percentage calculations Interpretation considerations This indicator only describes the proportion of rehospitalizations since discharge from rehabilitation Although the length of stay in hospital and reason for hospitalization are collected on follow up these indicators are not reported at the aggregate level Available metrics count percent CIHI 2015 105 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Clients Maintaining Function Score Gain Available in e NRS Comparative Reports gt Outcomes at Follow Up gt 3 Client Follow Up Count e NRS Analytical Reports gt Outcomes at Follow Up The number and percentage of clients with a Follow Up Total Function Score equal to or greater than their Discharge Total Function Score for all follow up assessments reported See Total Function Score in the section on Summary Functional Assessment Scores for further details on the calculation of this indicator Inclusions exclusions Requires completion of elements 41 to 58 on both the discharge and follow up assessments Interpretation considerations These scores may give some indication of the proportion of clients maintaining their functional levels post discharge For facilities that
180. oss RCGs e NRS Comparative Reports gt Admissions Profile gt 7 Functional Status at Admission to Facility e NRS Comparative Reports gt Outcomes at Discharge gt 2 Functional Status at Admission and Discharge from Facility NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up NRS Comparative Reports gt Resource Utilization gt 5 Functional Status Gain by RPG NRS Analytical Reports gt Admissions Profile NRS Analytical Reports gt Outcomes at Discharge NRS Analytical Reports gt Outcomes at Follow Up NRS Analytical Reports gt Resource Utilization gt RPG Case Mix and Functional Status Total Function Score is the sum of the scores from the 18 FIM instrument elements 41 to 58 inclusive in the data set Each element has a minimum score of 1 and a maximum score of 7 resulting in a value range of 18 to 126 This metric is the sum of the Total Function Scores for each admission record included in the report divided by the number of admission records Requires completion of all FIM instrument data elements 41 to 58 on the admission assessment Inclusions exclusions The Total Function Score is calculated from records containing complete FIM instrument codes for data elements 41 to 58 inclusive Records for which no CIHI 2015 117 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 FIM instrument assessment has been completed for example
181. own for the All comparison are based on the national average across all NRS submitting facilities regardless of designated facility type d Quick Indicator reports 1 to 9 permit drilling into the data from fiscal year to fiscal quarter See Section 7 7 for more information about drilling 7 Once the report contains the data that you are interested in and looks the way that you want you may choose to export save or print your newly created report For details about these options please refer to Chapter 8 Chosen Facility name and associated facility type will be displayed in the Page By boxes You may change the value that is selected in the Fiscal Year Page By box Figure 6 5 Example of a Graph Formatted Quick Indicator Report PAGE BY Discharge Fiscal Year 2012 2013 vy Facility Test Facility Site 00001 v Facility Type General Facility v x Rolling 6 fiscal years Single Value Single Value Data rows 13 Data columns 3 06 Average Length of Stay LOS Across Rehabilitation Client Groups RCGs Stroke Brain Dysfunction Neurological Conditions Spinal Cord Dysfunction Amputation of Limb Arthritis E Facility Peer E AI oO Pain Syndromes Vv Orthopedic Conditions Cardiac Pulmonary Burns Major Multiple Trauma Debility Medically Complex 0 0 CIHI 2015 25 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Chosen Facility name and associated facility type
182. ows editing and specification of totals and other functions for instance Minimum Maximum Average on the grid Toggle Thresholds Toggle predefined report threshold definition on or off Grid Toolbar Figure 7 5 The Grid Toolbar Grids only f cra rapt Format ere eee As m W aiifcsom E Blm a m lala Icons from left to right Save Save your result as a report template or filter Undo Undo the most recent action Redo Redo the most recent action Grid View report in grid format Graph View report in graph format Grid and Graph View report data in both grid and graph formats Autostyles Select a customized report style Banding Display coloured bands on the grid Outline Display data in a nested indent format Merge Column Headers Merge similar column names into one Merge Row Headers Merge similar row headers into one Lock Column Headers Lock column headers in place Lock Row Headers Lock row headers in place Auto Fit to Contents Rearrange grid size to fit data in the window frame CIHI 2015 37 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Auto Fit to Window Rearrange cell size to make cell content visible For more information about the options available in the Grid toolbar refer to Section 7 3 Graph Toolbar Figure 7 6 The Graph Toolbar Graphs only A Hil u verticalbar z ousterea
183. p right hand corner of the report grid or graph and lists the number of data rows and columns reported in the grid or the grid that would correspond with the displayed graph if the report is in graph form Note Some of these areas may not be visible by default You can turn them on or off by using the Tools menu located in the menu bar 7 2 Toolbar Below the pull down menu bar there exists a toolbar whose contents change depending on which menu tab Home Tools Data Grid Graph or Format has been selected Regardless of which tab is active the first six buttons remain the same Thereafter each tab will provide different buttons for the toolbar These buttons all correspond to functions that are also available through the drop down menus themselves The toolbar buttons that correspond to each tab are described below Note The tabs that are present at any given time depend on whether your report is formatted as a grid a graph or both Home Toolbar Figure 7 2 The Home Toolbar Home etd Vata a a gibt A T Y E E He Icons from left to right Save Save your result as a report template or filter Undo Undo the most recent action Redo Redo the most recent action Grid View report in grid format Graph View report in graph format Grid and Graph View report data in both grid and graph formats Add to History List Add the report to the History List ca
184. per range or higher values If the mean is lower than the median then the data is skewed to the left and there may be outliers in the lower range or lower values Standard Deviation Standard deviation defined as the square root of the variance of an indicator may be used to determine the percentage of observations that fall between the mean and any given value A high standard deviation indicates that many observations are far from the mean while a low standard deviation indicates that many observations are clustered around the mean Percentiles Some reports provide percentile metrics namely 25th and 75th percentiles A percentile is the value of a variable below which a certain percent of observations fall So the 25th percentile is the value below which 25 of the observations may be found The 25th percentile is also sometimes known as the first quartile the 75th percentile as the third quartile Facility Peer and All Metrics in the NRS eReports are typically provided for each of three levels Facility Peer and All so that facilities can compare their results with other participants in the NRS Each of these levels of metrics is described below Facility The indicators are calculated using data submitted by the facility for which the report is being generated Peer Peer groups in NRS eReports can be defined in any of three different ways i By Facility Type General or Specialty A peer group may be chosen
185. playing each quarter in a separate bar Series by Column When you switch to Graph or Grid and Graph view a Graph tab and toolbar will become available refer to Section 7 2 This will enable you to manipulate the look of your graph in order to show different trends that may exist in the data To return to a grid report click the Grid icon next to the Graph icon in the toolbar Tip If you are viewing a report with many attributes for example multiple facilities and outputs the resulting graph may be quite complex You may want to reduce the number of attributes you are trying to view if a graph is required Graph Formatting Graph formatting allows you to change the appearance of your graph Graph formatting options can be accessed by clicking on the Graph menu item in the Format menu The graph formatting panel will appear as a pop up window on the screen The following five tabs appear in the graph formatting panel General This tab allows you to make changes to the look and feel of the graph Options include changing graph type and subtype and changing the number of categories and series that display on the graph at the same time Format This tab allows you to make changes to the text fill and line styles and colours that appear on the graph Number This tab allows you to change the number format displayed in series labels Typically these are predefined according to the data that is present in the report
186. plicable and 29 Date Ready for Discharge on the discharge assessment Interpretation considerations This indicator is based on two other NRS indicators Change in Total Function Score and Active Rehab LOS both of which can be influenced by multiple factors such as complexity of the cases accepted by the facility client characteristics and availability of staffing resources amongst other things Care should be exercised when comparing this indicator to results from other facilities Available metrics average mean median standard deviation minimum maximum 25th percentile 75th percentile Admission Age Available in e NRS Comparative Reports gt Admissions Profile gt 6 Age at Admission to Facility e NRS Comparative Reports gt Outcomes at Discharge gt 1 Client Demographics e All NRS Analytical Reports except Resource Utilization Reports Age at admission to the rehabilitation facility Calculated by subtracting element 8 Birth Date from element 21 Admission Date Interpretation considerations Admission records include a data element to indicate if a client s birth date has been estimated 9 Birth Date Estimated Since all NRS admission records are included in the calculation of age indicators the accuracy of the values provided may vary depending on the number of records submitted for which the date of birth has been estimated Additionally the methodology for calculation of age rounds down to conform with other metho
187. ports Manual User Guide and Report Interpretation Guidelines April 2015 7 8 Filtering A filter sorts through the data in your data source and presents you with the specific information you request When you analyze a report it is important to understand the filter conditions that are being applied to the report This allows you to better understand what data is being excluded from the results By default the filter is not visible and must be selected You can see the existing filter conditions that were applied to the report by the report designer by selecting Report Details from the Tools menu The Report Details window shows the constraints that were used to design the report though the language in which they are described may be challenging for the average user You can apply further filter constraints to the current instance or view of a report by using a View Filter The View Filter limits the data being displayed on a report without re executing the report against the data source To create one or more View Filters click on Add Condition in the View Filter window If this window is not currently visible at the top of your report select View Filter from the Tools menu Proceed to define the condition s on which the data should be filtered and then click the check mark Apply button To remove a particular filter click on the Cancel button beside it Alternatively you can narrow your view of a report to only the rows and colu
188. pretation Guidelines April 2015 1 Introduction to NRS eReports 1 1 What Is the NRS eReports System The National Rehabilitation Reporting System NRS eReports system is a secure and confidential online service that provides authorized users with a unique ability to view and analyze administrative and clinical NRS data It is available to organizations submitting data to the NRS their health authorities and ministries of health The NRS eReports system provides these users with a customized view of selected administrative and clinical NRS data to facilitate evidence based decision making and comparisons within the Canadian health care system The NRS eReports system is powered by MicroStrategy s suite of business intelligence tools MicroStrategy was chosen by CIHI for its comprehensive set of reporting and analysis features What NRS eReports can Offer Information e Client demographics and function indicators resource utilization indicators and other outputs for the most recent six fiscal years and e Facility peer and national results Functionality Selection of peers for comparison Manipulation of the appearance of reports Graph creation Exporting or saving data to Excel or PDF files and Ability to save report templates to allow for easy quarterly recreation of preferred reports 1 2 Who Has Access to NRS eReports NRS eReports are available only to authorized users identified by organizations participating in the
189. primarily based on rehabilitation episodes Exception Clients recorded as having an Un planned Discharge are still considered to have had a rehabilitation episode in the NRS see Un planned Discharge Expression FIM instrument Includes clear vocal and or non vocal expression of language This item includes either intelligible speech or clear expression of language using writing or a communication device Expression of intent can involve simple and or complex ideas with scores reflected accordingly F Facility Refers to the site where the rehabilitation beds are grouped and represents the level at which hospitals submit data for the NRS Often facility is synonymous with hospital For hospitals with more than one site or location there may be more than one NRS facility within a hospital corporation CIHI 2015 139 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 FIM instrument The functional assessment instrument included in the Uniform Data Set for Medical Rehabilitation UDSwa_ It is composed of 18 items 13 motor items and 5 cognitive items that are rated on a seven level scale representing gradations from independent 7 to dependent 1 function The FIM instrument is a measure of disability and looks at the caregiver burden associated with the level of disability Follow up FIM instrument Assessment The assessment of the client s functional ability using the
190. r location Additionally the Page By feature allows you to create a third dimension to the report by placing one or more objects onto the Page By axis The Page By feature allows you to separate your report data into distinct pages that can be viewed separately The Page By feature can save you time by allowing you to view what looks like multiple reports without having to re query the database For example if Province is one of the attributes in a report and you moved it to the Page By axis you would be able to look at the data in the report one province at a time How to modify the report layout Moving objects using Pivot Buttons 1 Display the report in grid view 2 Open the Tools drop down menu 3 Select Pivot Buttons 4 Use Pivot Buttons to move objects to rows columns or page items 5 Repeat Step 4 until desired data layout on grid is achieved Moving objects by dragging 1 Display the report in grid view 2 Left click on mouse hold and drag object header to desired position on grid CIHI 2015 43 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 7 6 Sorting You can sort any column of data in a report Choosing a column to arrange its values in ascending or descending order rearranges data in all columns appropriately There are two ways that you can sort data in a column The first way is to right click on the column header and select Sort Ascending or Sort Descending The
191. ral admission discharge and follow up indicators All nine graphs have identical properties each reporting on a different indicator Reports present information based on facility facility type general or specialty and desired fiscal year Indicators are presented at the Facility Peer and National All levels You will be prompted only for your facility name and number in order to generate the report NRS Comparative Reports Comparative Reports allow a bit more flexibility than Quick Indicator reports but require slightly more time and effort to build at least initially They provide a comprehensive set of NRS indicators at the Facility Peer and National All levels for any of the most recent six fiscal years There are four categories of Comparative Reports i Admission Profile reports ii Outcomes at Discharge reports iii Outcomes at Follow Up reports and iv Resource Utilization reports Each category includes up to seven different types of reports that can be generated e g Age at Admission Functional Status at Discharge Follow up Living Setting You can select options for various factors including peer group Rehabilitation Client Group RCG and the reporting period In most cases reports can be viewed as tables or graphs NRS Analytical Reports Analytical Reports are build your own reports that allow even greater flexibility but require a bit more time and effort to produce than the other two types of reports A
192. rative Report you have chosen to generate you will be prompted to select values through which to filter the data There are four possible types of prompts that you may encounter in Comparative Reports a Facility allows you to select your facility by name number only one facility name number permitted b Fiscal Year s allows one or more fiscal years for which to view data c Rehabilitation Client Group s allows selection of one or more RCG of interest if no selection is made reports will be generated for all RCGs by default d Peer Group allows selection of a comparison peer group based on one of facility type or number of beds or facility name choose only one of these grouping methods when selecting your peer group Note Defining a Peer Group is optional to the user The Default for the Peer Group will be All Facilities as such an aggregated value for all Facilities will be displayed if no peer group is designated Some of the above prompts will be marked as required in these cases you must make a selection before proceeding or you will receive an error message 5 Once you have made selections for all of the necessary prompts click Run Report in the bottom left hand corner A wait page will appear while your report is being created see Section 6 6 for more information on the wait page This page appears because the reports are created on demand based on information you have asked for Report creation may take
193. rauma Other Multiple 14 9 8 4 2800 to 2840 Trauma and Major Multiple Fracture 28 Major Multiple Trauma With Brain or 14 1 14 2 14 3 2900 to 2920 Spinal Cord Injury 29 Ventilator Dependent Respiratory 17 51 3000 Disorders 30 Other Disabilities 31 12 1 12 9 13 1 15 1 16 1 17 1 17 2 3100 to 3140 17 31 17 32 17 4 17 52 17 6 17 7 17 8 17 9 CIHI 2015 85 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Sex Available in e NRS Comparative Reports gt Admissions Profile gt 6 Age at Admission to Facility e All NRS Analytical Reports Describes the biological sex of a client Permits grouping of clients by sex In Comparative Reports includes male and female In Analytical Reports also includes category other where applicable CIHI 2015 86 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 14 In Depth NRS Metrics 14 1 Overview In response to feedback from a consultation process on health information needs CIHI launched a collaborative project on health indicators The purpose of the project was to identify which measures could and should be used to report on the health of Canadians and the health system and then to compile and disseminate the information widely The NRS is one of a number of CIHI databases that contribute key information to the resulting CIHI Indicator Framework An indicator can be defin
194. re should be used when this indicator is used in isolation to compare between the facility peer and national levels CIHI 2015 112 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Available metrics average mean median standard deviation minimum maximum 25th percentile 75th percentile count Length of Stay Efficiency Available in e NRS Quick Indicators gt 7 Average Length of Stay LOS Efficiency Across RCGs e NRS Comparative Reports gt Outcomes at Discharge gt 5 Length of Stay and Service Interruptions NRS Comparative Reports gt Resource Utilization gt 5 Functional Status Gain by RPG NRS Analytical Reports gt Outcomes at Discharge NRS Analytical Reports gt Outcomes at Follow Up NRS Analytical Reports gt Resource Utilization The change in Total Function Score per day of client participation in the rehabilitation program Calculation is based on Total Function Score Change divided by LOS for each client averaged over the number of clients As with the LOS indicator service interruption days are not included Inclusions exclusions Requires completion of elements 41 to 58 all FIM instrument items on both the admission and discharge assessments 21 Admission Date on the admission assessment and 25A B Service Interruption Dates if applicable and 30 Discharge Date on the discharge assessment Interpretation considerations The LOS Efficiency indicator is based on tw
195. reate a report and after clicking on the Run Report button you will be presented with a wait page The Wait Page appears while the report is being generated and it contains the report name and its current execution status When the report has finished being executed against the database the Report screen see Section 7 1 automatically replaces the Wait Page What If I Don t Want to Wait for the Report to Run Although every effort has been made to optimize the database for fast query performance certain very large or complex queries may take longer to run than you would like What options do you have if this happens Below are the four different options presented on the Wait Page Check Status Again Selecting this option forces the Wait Page to refresh Note The Wait Page will also refresh automatically at an interval specified by the CIHI Administrator Add to My History List Selecting this option allows the report to keep running while you perform other tasks with the software When you have finished the other tasks you can go to the History List and open the stored results of the completed report without having to wait Cancel Selecting this option allows you to completely cancel the execution of the report and be returned to the page where the selected report is saved Show Report Details Selecting this option allows you to view information such as the report description filter definition run time and number of rows re
196. records with Admission Class 4 Un planned Discharge are excluded Interpretation considerations The Total Function Score at Admission can be compared at the facility peer and national levels or to the Average Discharge Function Score for that facility Refer to the NRS Rehabilitation Minimum Data Set Manual for more detailed information on coding the various FIM instrument elements A more complete picture of client function can be obtained by breaking down the Total Function Score into its motor and cognitive components see below Available metrics average mean median standard deviation minimum maximum Total Function Score at Discharge Available in e NRS Quick Indicators gt 3 Average Discharge Total Function Score Across RCGs e NRS Comparative Reports gt Outcomes at Discharge gt 2 Functional Status at Admission and Discharge From Facility NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up NRS Comparative Reports gt Resource Utilization gt 5 Functional Status Gain by RPG NRS Analytical Reports gt Outcomes at Discharge NRS Analytical Reports gt Outcomes at Follow Up NRS Analytical Reports gt Resource Utilization gt RPG Case Mix and Functional Status Total Function Score is the sum of the scores from the 18 FIM instrument elements 41 to 58 inclusive in the data set Each element has a minimum score of 1 and a maximum score of 7 resulting in a value range of 1
197. response choices for this element are as follows clinicians must code all that apply Living with spouse partner Living with family includes extended Living with non family unpaid includes friends Living alone Living in facility includes all levels of care except acute Other 50 Not available temporarily 70 Asked unknown 2 3 4 Living with paid attendant 5 6 7 For reporting purposes the response choices have been grouped as follows Living with family friends unpaid code 1 or 2 or 3 excluding code 4 Living with family friends paid attendant code 1 or 2 or 3 and 4 Living with paid attendant only code 4 only Living alone code 5 Living in facility nursing home code 6 Other code 7 Inclusions exclusions Response codes 50 Not available and 70 Unknown are included in the denominator for percentage calculations It is possible for a client to be coded with more than one living arrangement for example living with spouse and family but each client is counted only once in the calculation of N and percentages This indicator along with Admission by Pre Hospital Living Setting provides information on the home environment prior to admission and can be compared to the post discharge environment in the measurement of outcomes Pre Hospital Living Setting Available in e NRS Comparative Reports gt Admissions Profile gt 5 Admission by Pre Hospital Setting e NRS Analytical Reports gt Admissi
198. retation considerations Change in function indicators are expressed as averages A positive value indicates a score increase and a negative value indicates a score decrease Available metrics average mean median standard deviation minimum maximum CIHI Cognitive Score This is the sum of the CIHI Cognitive elements 64 to 69 inclusive four Communication elements one Financial Management element and one Orientation element and describes the client s level of function as it pertains to the additional cognitive elements tested in the NRS Refer to the NRS Rehabilitation Minimum Data Set Manual for details on score ranges as the scales vary between these elements The CIHI Cognitive Score further assesses cognitive function in addition to the FIM instrument Cognitive Function Score Inclusions exclusions Includes all records for ages older than 13 where element 19A Admission Class is initial rehabilitation continuing rehabilitation short stay or readmission class and element 63 Presence of Cognitive Communication Activity Limitations is coded as Yes and element 79 Glasses Hearing Aid Flag is coded as No or left blank Interpretation considerations gt The CIHI Cognitive elements were found to be valid and reliable in the assessment of cognitive function by the National Rehabilitation Advisory Group and were also shown to improve precision of measurement of cognitive domain over the FIM instrument cognitive sub scale
199. rge assessment Interpretation considerations This indicator describes only those clients showing an increase in Pain Score over the course of the rehabilitation stay Note that a higher Pain Score in this case represents less overall pain and or fewer activities restricted by pain The balance of the percentage value represents clients who showed either no change in Pain Score or a decrease in Pain Score from admission to discharge or were unable to be assessed for that element Additionally element 59 Impact of Pain is based on the client s perception of the overall pain level rather than a measured observation and therefore has a qualitative nature CIHI 2015 107 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Available metrics count percent Clients Reporting Worsening of Pain Available in e NRS Comparative Reports gt Outcomes at Discharge gt 3 Clinical Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Discharge The number and percentage of clients reporting pain on discharge that had reported no pain on the admission assessment or those reporting a greater degree of pain on discharge than was recorded on admission Comparison is based on the results coded for elements 59A C Impact of Pain These elements were derived from the 1996 National Population Health Survey developed by Statistics Canada This is one of the outcome indicators in the NRS and is based on client rep
200. rical trending of CMI 5 Function Status Gain by RPG View the length of stay and length of stay efficiency indicators as well as functional changes from admission to discharge at the facility peer and national levels by Rehabilitation Patient Group for the reporting period 6 Regional Case Mix Report Original Methodology View case mix indicators for the provincial health regions based on rehabilitation cost weights and length of stay trim point values originally in use during the chosen fiscal year 7 Regional Case Mix Report Current Methodology View case mix indicators for the provincial health regions based on current rehabilitation cost weights and length of stay trim point values Reports 1 to 4 are RPG Patient Days and Case Mix Index CMI reports These reports provide information on Rehabilitation Patient Groups RPGs at a facility level for the reporting period selected for each of the indicators below If a facility had no clients who were allocated to a particular RPG during the period to which the report relates the row for that RPG will contain zeros Reports 6 and 7 are Case Mix reports that show case mix indicators grouped by health region rather than by RPG and by Facility Peer and All groups These reports may be of more interest to health regions and provincial ministries of health than to users at individual facilities For further details on the methodologies used in these reports facilities are directed to the
201. rts The number of rehabilitation beds in operation at the facility as defined by the facility For NRS eReporting purposes numbers of beds are grouped as follows 0 10 11 20 21 30 31 40 41 50 51 75 76 100 101 200 gt 200 Post Discharge Living Arrangements Available in e NRS Analytical Reports gt Outcomes at Discharge Describes the distribution of clients discharged to various living arrangements based on the response choice for data element 13 Post Discharge Living Arrangements The response choices for this element are as follows clinicians must code all that apply Living with spouse partner Living with family includes extended Living with non family unpaid includes friends Living with paid attendant Living alone Living in facility includes all levels of care except acute Other Living arrangement s is are transitional or temporary o AON Oa RA OO N Living in acute care a oO Not available temporarily CIHI 2015 78 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 70 Asked unknown Pre Hospital Living Arrangements Available in e NRS Comparative Reports gt Admissions Profile gt 4 Admission by Pre Hospital Living Arrangements e NRS Analytical Reports gt Admissions Profile Describes the distribution of clients admitted from various living arrangements based on the response choice for data element 12 Pre Hospital Living Arrangements The
202. s Also referred to as the Average Median The middle value in a group when the values are arranged in an increasing order If there is an even number of values the median is the average of the middle two values For example in the series 2 5 7 9 12 the value 7 is the median Median is not calculated in the same way as Mean or Average but it may sometimes result in the same value as in the example shown here Memory FIM instrument Memory in this context includes the ability to store and retrieve information particularly verbal and visual The functional evidence of memory includes 1 recognizing people frequently encountered 2 remembering daily routines and 3 executing requests without being reminded Metrics Refers to the numerical data such as percentages counts N or a variety of summary statistics for example mean median standard deviation that summarize each of the demographic clinical and administrative indicators available in NRS eReports for example number of clients length of stay Total Function Score A full listing and description of available metrics is provided in Chapter 14 Most Responsible Health Condition The primary etiological diagnosis that describes the most significant condition leading to the client s rehabilitation stay Where multiple conditions exist it is the one health condition that is most related to the Rehabilitation Client Group and the condition that most of the reso
203. s count percent Clients Admitted Available in e NRS Comparative Reports gt Admissions Profile gt Reports 1 to 6 e NRS Analytical Reports gt Admissions Profile Clients admitted to rehabilitation in a particular reporting period Available metrics count percent Clients Discharged Available in e NRS Comparative Reports gt Outcomes at Discharge gt 1 Client Demographics e NRS Comparative Reports gt Outcomes at Discharge gt 4 Discharge Destination e NRS Analytical Reports gt Outcomes at Discharge Clients discharged from rehabilitation in a particular reporting period Inclusions exclusions Clients with Admission Class 4 or Discharge Reason 8 are excluded from this count Available metrics count percent Clients Home Prior to Admission Available in e NRS Analytical Reports gt Outcomes at Discharge This indicator looks at the count of clients who were home prior to their inpatient rehabilitation stay Requires completion of 14 Pre Hospital Living Setting Inclusions exclusions This metric includes all records in which clients had Pre Hospital Living Setting 1 2 or 3 Clients with Admission Class 4 or Discharge Reason 8 are excluded from this count CIHI 2015 104 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Available metrics count Clients Discharged Home Who Were Home Prior to Admission Available in e NRS Quick Indicators gt 8 Percent D
204. s of several Admission Discharge View a comprehensive set of NRS indicators at the and Follow up Indicators for each Rehabilitation Client Facility Peer and National levels for the last 5 fiscal Group at the Facility Peer and National levels for the last years Users can select options for various factors 5 fiscal years Peer Groups are based upon induding peer group RCG and reporting period Reports General Specialty facility types can be viewed as tables or graphs Peer Information Report for Facilities Submitting Follow up Data Owner Administrator ae Modified 2 14 11 1 25 59 AM View up to date and historical information regarding facility type bed numbers and facility location for all facilities submitting follow up data to the NRS This information can be used to aid users in the selection of appropriate peers Export PDF 3 NRS Analytical Reports Owner Administrator Modified 7 14 09 7 16 31 AM Build your own report to analyze Admission Profile Outcomes at Discharge Outcomes at Follow up and Resource Utilization for the last 5 fiscal years Customize your report by choosing what indicators to indude and how to display your report Peer RCG Information Report Owner Administrator Modified 11 26 10 12 28 25 AM a View up to date and historical information regarding facility type bed numbers facility location and discharges by RCG for all facilities submitting data to the NRS This information c
205. s with Comparative Reports you may select one of four categories However unlike Comparative Reports Analytical Reports allow you to display data based on any available attributes and metrics CIHI 2015 151 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 eReports Permissions amp Exclusions If a user is part of an NRS submitting facility and has access to the NRS eReports the user will be able to view all NRS eReports upon logging into CIHI Portal If a user has access to CIHI Portal but does not have access to the NRS eReports the user will be able to view all but five of the NRS eReports The following five NRS eReports will be hidden due to their lack of applicability to said user e NRS Quick Indicators gt 10 Data Quality Indicators e NRS Comparative Reports gt Resource Utilization gt 1 RPG Patient Days Report e NRS Comparative Reports gt Resource Utilization gt 2 RPG Patient Days Report Most Recently Completed Fiscal Quarter e NRS Analytical Reports gt Resource Utilization gt 3 RPG Patient Days Peer Comparisons e NRS Analytical Reports gt Resource Utilization gt 4 RPG Patient Days Multiple Facilities Important NRS Data Notes Years of Data NRS data for fiscal years 2000 2001 to present have been loaded into the data mart and are now available for ad hoc reporting in Portal The NRS eReports within CIHI Portal permit displaying of data for any of the most
206. scharge e NRS Analytical Reports gt Outcomes at Follow Up Requires completion of all CIHI Cognitive elements 64 to 69 on the discharge assessment Inclusions exclusions Includes all records for ages older than 13 where element 19A Admission Class is initial rehabilitation continuing rehabilitation short stay or readmission class and element 63 Presence of Cognitive Communication Activity Limitations is coded as Yes and element 79 Glasses Hearing Aid Flag is coded as No or left blank Interpretation considerations CIHI Cognitive elements with a score of 8 are recoded as 1 for the purposes of this calculation The CIHI Cognitive Score at Discharge can be compared at the facility peer and national levels or to the CIHI Cognitive Score at Admission for that facility The score can be considered along with indicator distributions such as Rehabilitation Client Group Reason for Discharge Discharge Living Setting and Arrangement to give a clearer picture of the typical discharge situation for a rehabilitation client Available metrics average mean median standard deviation minimum maximum CIHI Cognitive Score at Follow Up Available in e NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up CIHI 2015 125 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 e NRS Analytical Reports gt Outcomes at Follow Up Requires completion of all CIHI Cognitive elements
207. second way is by using the Tools menu When Sort Buttons is selected from the Tools menu arrows will display beside each of the row and column headers e If the arrow is shaded grey 7 the column is not sorted e If the arrow is white and pointing up the column is sorted in ascending order e If the arrow is white and pointing down lt 7 the column is sorted in descending order To sort a single column of data click on the arrow beside the column heading one click will sort the data in descending order and a second click will reverse the sort You are also able to sort multiple columns of data by using the Sort menu How to sort Sorting by right clicking 1 Display the report in grid view 2 Right click on the attribute name or heading in the grid 3 Select Sort Descending or Ascending Sorting using Sort Buttons 1 Display the report in grid view 2 Open the Tools drop down menu 3 Select Sort Buttons 4 Click on Sort Buttons to sort data in desired order For advanced or combination sorting Display the report in grid view Open the Data drop down menu Select Sort Define the sorting configuration Click Apply Click OK DOV BOO NS 7 7 Drilling Drilling refers to looking at your data at a different level of analysis For instance you might drill down to look at more specific groupings of data If data is shown for a particular fiscal year for example you might drill down to view the data at
208. sion By default data is shown by age group and sex 7 Functional Status at Admission to Facility View functional status indicators of clients admitted during the defined reporting period Indicators include Total Function Score and CIHI Cognitive Score 11 4 Outcomes at Discharge Comparative Reports The following section describes the contents of the Outcomes at Discharge folder There are five Outcomes at Discharge Comparative Reports available in this folder These reports include summary data for clients discharged during the chosen reporting period and allow for peer and national comparisons For more information about the attributes and metrics contained in these reports refer to chapters 13 and 14 respectively Data included in Outcomes at Discharge Comparative Reports are based on episodes that contain complete admission and discharge assessments 1 Client Demographics View demographic indicators for clients discharged during the defined reporting period Indicators include number of clients average age percent of males versus females number of clients for whom a complete FIM and CIHI Cognitive assessment was conducted number of clients with service interruptions and number of service interruptions and average admission body weight and body mass index BMI values 2 Functional Status at Admission and Discharge From Facility View functional status indicators of clients discharged during the defined reporting period Both fu
209. t 6 Average Length of Stay LOS Across RCGs e NRS Comparative Reports gt Outcomes at Discharge gt 5 Length of Stay and Service Interruptions NRS Comparative Reports gt Resource Utilization gt 5 Functional Status Gain by RPG NRS Analytical Reports gt Outcomes at Discharge NRS Analytical Reports gt Outcomes at Follow Up NRS Analytical Reports gt Resource Utilization The number of days from element 21 Admission Date to element 30 Discharge Date minus any Service Interruption days if applicable for each completed admission and discharge record pair averaged over all records Admission Date is included in the count of days for admission class 4 for example Discharge Date minus Admission Date must be less than 4 days 0 3 days for a length of stay including the admission date Inclusions exclusions Length of Stay excludes Service Interruption Days but includes Days Waiting for Discharge Requires completion of element 21 on the admission assessment and 25A B Service Interruption Dates if applicable and 30 on the discharge assessment Depending on the report Un planned Discharges may be excluded as the discharge record is not completed Clients admitted and discharged on the same day have an LOS of 1 day Interpretation considerations Length of Stay can be influenced by many factors such as complexity of the cases accepted by the facility and number of days waiting for discharge due to delays in the discharge process Ca
210. t rehabilitation There are 83 RPGs which are stratified from 21 Rehabilitation Groups RGs Placement into a specific RG depends on the coded RCG for each patient and assignment into a specific RPG is further based on Motor and Cognitive Function Scores at Admission and age These factors are used to report client data in more clinically homogeneous groups for better comparability For further details on the specific RPG algorithms please consult CIHI s Rehabilitation Patient Group RPG Grouping Methodology and Weights document available from the CIHI website at www cihi ca casemix Each Rehabilitation Group has at least one RPG The lower RPG numbers for a given RG are made up of clients that generally have lower Function Scores on admission based on FIM CIHI 2015 83 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 instrument In certain levels of the classification of select RGs client age is also used as a grouping factor Conversely the higher RPG numbers for a given RG are made up of a group of clients who have higher Function Scores at admission As above age is again used at certain levels as a grouping factor For example within the Stroke RG there are seven RPGs 1100 to 1160 The first two RPG digits indicate the Stroke RG The last two RPG digits represent the specific RPG Clients grouped in the lower two RPGs 1100 1110 will have lower admission Function Scores compared w
211. tandard categories underweight lt 18 5 normal 18 5 24 9 overweight 25 30 and obese gt 30 A fifth category unable to calculate is used in the NRS eReports to capture clients for whom a BMI could not be calculated because of a missing height element 40A or weight element 40B value for instance Note that BMI data is only available in NRS eReports for fiscal years 2009 2010 and later due to changes in NRS coding specifications Interpretation considerations BMI values are calculated for clients that have height and weight elements 40A and 40B data available regardless of the accuracy of the values coded for these elements As such some clients may have BMI values that seem unreasonable or unlikely This may be due to various measurement or coding issues e g submitting a weight measured in pounds instead of kilograms a height measured in inches rather than centimetres etc Discharge Destination Available in e NRS Comparative Reports gt Outcomes at Discharge gt 4 Discharge Destination e NRS Analytical Reports gt Outcomes at Discharge Describes the number and percentage distribution of various post discharge destinations based on all discharge records submitted This indicator is derived from three data elements that must be completed on the discharge assessment 15 Post Discharge Living Setting 32 Referred To and 31 Reason for Discharge 15 Post Discharge Living Setting 32 Referred To 31 Reason
212. tation Goals The functional objectives set by the client in partnership with the rehabilitation team These are determined shortly after admission to the rehabilitation facility and generally form the basis for activities that will be included in the rehabilitation program Rehabilitation Group RG A type of categorization representing the highest level of diagnostic classification for clinically similar patients and used in the RPG case mix grouping methodology for the NRS The RPG methodology was developed by Ontario s Joint Policy and Planning Committee JPPC using data from the NRS and other sources for Ontario facilities Assignment to any of the 21 RGs is based on the Rehabilitation Client Group RCG code selected for each NRS record Each patient is assigned to an RG based on their RCG which is combined with other variables to assign each patient to an RPG Rehabilitation Patient Group RPG A sub classification of Rehabilitation Groups RG in inpatient rehabilitation case mix grouping methodology developed by Ontario s Joint Policy and Planning Committee JPPC using NRS data for Ontario facilities Patients are assigned to one of the 83 specific RPGs based on a combination of RG Admission Motor Function Score and or CIHI 2015 143 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Admission Cognitive Function Score derived from data collected using the FIM instrument and or age Each R
213. ted Functional Status at Admission report every quarter without having to reselect the RCGs and the peer grouping you are interested in each time and without reformatting it the way you like To do this save the report you have created to My Reports and make sure the Keep Report Prompted box in the lower left corner is unchecked If you save the report with this boxed unchecked you can go directly to My Reports each quarter and select that report and the data will be refreshed automatically Note that the My Reports folder is always displayed in the Navigation toolbar at the top of every screen Note also that reports saved to your My Reports folder are only accessible by you other users cannot view this reports If you wish to share a report with other NRS eReports users save your report to the User Defined NRS eReports folder found in the Shared Reports folder All NRS eReports users have access to this folder so saving here means that anyone else may run the report that you have created Tip If the report needs to be saved in a computer directory so that a static version is available the report must be exported using the PDF or Export features as described in Section 8 2 If you export a report and save it to your computer it will not refresh every quarter How to save a report Display the report in grid or graph view Open the Home menu Select Save As Select the desired location to save the report Define a name for
214. terruptions are generally coded only when the client misses more than one day of active rehabilitation and the condition is felt to impact the client s progress in rehabilitation This does not include weekend passes to visit family at home or temporary bed closures Available metrics count Total Service Interruption Days Available in e NRS Comparative Reports gt Outcomes at Discharge gt 5 Length of Stay and Service Interruptions e NRS Analytical Reports gt Outcomes at Discharge e NRS Analytical Reports gt Outcomes at Follow Up The number of days occurring during service interruptions Sls Total SI Days is calculated by summing the number of days in each reported service interruption the difference between 25B SI End Date and 25A SI Start Date Inclusions exclusions In some cases the metrics associated with this indicator refer to SI Days in a given episode For instance SI Days MAX refers to the maximum number of SI Days that occurred in a client episode of care SI Days AVG however refers to the average number of SI Days per SI Available metrics average mean standard deviation minimum maximum count Weight kg at Admission Available in e NRS Comparative Reports gt Outcomes at Discharge gt 1 Client Demographics e NRS Analytical Reports gt Admissions Profile e NRS Analytical Reports gt Outcomes at Discharge CIHI 2015 116 NRS eReports Manual User Guide and Report Interpretation Guide
215. the FIM instrument and allows for a better comparison of motor function between FIM instrument assessments Available metrics average mean median standard deviation minimum maximum Motor Function Score at Follow Up Available in e NRS Comparative Reports gt Outcomes at Follow Up gt 4 Functional Status at Follow Up e NRS Analytical Reports gt Outcomes at Follow Up This is the sum of the 13 FIM instrument elements 41 to 53 inclusive that assess various components of motor function self care sphincter control transfers etc at the time of follow up assessment The Motor Function Score ranges from 13 to 91 and provides a score that describes a client s motor function based on the elements tested Inclusions exclusions Motor Function Score is calculated from follow up records containing complete FIM instrument Total Function Scores that is both motor and cognitive components Records for which no FIM instrument assessment has been completed are excluded Interpretation considerations The Motor Function Score isolates the motor components of the FIM instrument and allows for a better comparison of motor function between FIM instrument assessments Available metrics average mean median standard deviation CIHI 2015 121 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Motor Function Score Change Available in e NRS Comparative Reports gt Outcomes at Disch
216. the last 5 fiscal years Peer Groups are based upon General Specialty facility types 3 NRS Analytical Reports Owner Administrator 2 NRS Comparative Reports Owner Administrator Modified 12 15 10 2 17 20 PM View a comprehensive set of NRS indicators at the Facility Peer and National levels for the last 5 fiscal years Users can select options for various factors including peer group RCG and reporting period Reports can be viewed as tables or graphs Peer Into Report for Facilities Submitting Follow up Data Owner Administrator Modified 7 14 09 7 16 31 AM Modified 2 14 11 1 25 59 AM Build your own report to analyze Admission Profile aae View up to date and historical information regarding Outcomes at Discharge Outcomes at Follow up and ae facility type bed numbers and facility location for all Resource Utilization for the last 5 fiscal years Se facilities submitting follow up data to the NRS This Customize your report by choosing what indicators to include and how to display your report Peer RCG Information Report Owner Administrator Modified 11 26 10 12 28 25 AM e ag View up to date and historical information regarding Ta facility type bed numbers facility location and oe discharges by RCG for all facilities submitting data to the NRS This information can be used to aid users in the selection of appropriate peers Export PDF information can be used to aid users in the sel
217. the level of reporting periods that is quarters Alternatively you could drill down from national level data to provincial level Drilling up refers to looking at less specific larger groupings of data For instance you might choose to collapse data across various age groups if age was not an important factor in your analysis In this case you are drilling up from the level of age groups Likewise if you were only interested CIHI 2015 44 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 in overall number of clients requiring rehabilitation for a particular impairment you might drill up from the level of sex that is collapse data across both sexes Drilling allows you to explore different levels of information within a report The following are ways to drill to another level of detail once you have run your report Hyperlink Drilling A hyperlink underlined text in a report has an associated default drill level for example the default drill level for Province could be Facility To drill to this associated default level simply click on the hyperlink The report will refresh and the data will appear with a new level of detail To drill using a hyperlink 1 Display the report in grid view 2 Click on any hyperlinked data element Right Click Drilling You can access the drill menu by right clicking on any attribute header for example Province or attribute element for example Saskatche
218. ting options available or directly select Show Printable Version to print the report using the default settings available for the software A PDF version of the report will appear and the Print icon on the menu toolbar must be selected in order to send the document to be printed Tip When graphing data there are times when the title representing a data element may be too long to be fully displayed in the legend of the printed graph This issue can be resolved by selecting Show Advanced Options on the Print options page then checking the box for Use Bitmaps for Graphs option Now the graph legend will display the full titles belonging to each data element CIHI 2015 50 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Part 2 NRS eReports Report Interpretation Guidelines Chapter 9 Chapter 10 Chapter 11 Chapter 12 Chapter 13 Chapter 14 Chapter 15 Data Submission and Reporting In Depth NRS Quick Indicators In Depth NRS Comparative Reports In Depth NRS Analytical Reports In Depth NRS Attributes In Depth NRS Metrics Additional Help With NRS eReports CIHI 2015 51 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 9 Data Submission and Reporting 9 1 Population of Reference The data contained in the NRS eReports database relates primarily to adults 18 and older with physical and or cognitive impairments and functional limitations who have rec
219. tion The Facility prompt will e Offer rehabilitation facilities by name and number that have submitted data to the NRS e Allow only one choice e Have search capabilities and e Be sorted alphabetically by facility name Page By Axis The Page By axis at the top of each Quick Indicator report will contain the following Page By labels each displaying one value e Facility e Facility Type e Fiscal Year or Fiscal Quarter if you have already drilled from year to quarter Common Functionality All of the different Quick Indicator reports share the following functionality CIHI 2015 60 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 1 Once a report is run users are able to choose the Fiscal Year Page By to display the given report for any of the six given fiscal years Since the most recent fiscal year may still be in progress it will effectively contain year to date data for the most recent fiscal year The first nine reports also permit drilling from fiscal year to fiscal quarter so that users may view quarterly data 2 Peer grouping is based on the facility type general or specialty defined for that facility for that fiscal year Designation of General or Specialty is chosen by each facility and submitted as part of its Facility Profile 3 Users are able to save or export any Quick Indicator report 4 The filter details will be displayed above the report by default 10 2 At
220. tive Reports The four types of Analytical Reports that can be built are the following 1 Admissions Profile Build your own report to analyze admission indicators including client characteristics age sex and functional status at admission 2 Outcomes at Discharge Build your own report to analyze discharge indicators including client characteristics age sex outcomes at discharge and functional status at admission and discharge Wait times length of stay and service interruption data is also available for analysis 3 Outcomes at Follow Up Build your own report to analyze follow up indicators including client characteristics age sex and functional status at admission discharge and follow up Other indicators such as length of stay and service interruptions are also available for analysis 4 Resource Utilization Build your own report to analyze resource utilization and case mix indicators by Rehabilitation Group and Rehabilitation Patient Group CIHI 2015 69 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 These four folders contain two types of Analytical Reports One report type permits selection of a single facility and an associated peer group as in the NRS Comparative Reports This type of report will display data at the Facility Peer and All levels The second report type does not permit selection of a peer group However it does allow you to select multiple facilities in the Facili
221. to 13 Inclusions exclusions Response codes 50 Not available and 70 Unknown are included in the denominator for percentage calculations Excludes Un planned Discharge records Rehabilitation Client Group Available in e All NRS Quick Indicators except the Data Quality Indicators Report e All NRS Comparative Reports except Resource Utilization reports e All NRS Analytical Reports Within the NRS a client is categorized into 1 of 17 health condition groups known as Rehabilitation Client Groups RCGs The RCG selected for a particular client is based on the condition that best describes the primary reason for the client s admission to the inpatient rehabilitation unit or facility for example stroke or limb amputation Some RCGs are further divided into subgroups in order to facilitate more specific analysis of groups that contain large numbers of rehabilitation clients for example left and right sided strokes Most NRS eReports outline only the 17 major groups though the NRS Analytical Reports allow for drilling down to the more specific level of RCG Subgroup The 17 major RCG groups are as follows 1 Stroke Brain Dysfunction Neurological Conditions Spinal Cord Dysfunction Amputation of Limb Arthritis Pain Syndromes NO noS oN CIHI 2015 82 O NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 8 Orthopedic Conditions 9 Cardiac 10 Pulmonary 11 Burns 12 Congenital Def
222. to right Save Save your result as a report template or filter Undo Undo the most recent action Redo Redo the most recent action Grid View report in grid format Graph View report in graph format Grid and Graph View report data in both grid and graph formats CIHI 2015 36 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Add View Filter Condition Display or hide the View Filter window Sort Display or hide the Sort Options window You can sort based on up to three data elements in ascending or descending order Drill Open Drill Options window You can drill to higher or lower levels of data in the hierarchy Refer to Section 7 7 for more information about drilling Filter on Selections Select rows and or columns to be removed from the currently displayed report Re run Report Refresh the report with data retrieved from the latest valid cache Re prompt Return to the Prompt screen to make changes to your report selections Swap Rows and Columns Change the view of the data in the grid by swapping rows and columns Insert New Metric Add a pre existing or newly defined metric to the grid Rename Edit Objects Open a window to allow for renaming or editing of an attribute or metric Toggle Attribute Forms Display the different forms of the attribute Toggle Totals Display or hide totals from the grid Edit Totals All
223. tributes and Metrics Available in NRS Quick Indicators The attributes that are available in the different NRS Quick Indicators are listed in Table 13 1 in Chapter 13 For attribute definitions inclusion exclusion criteria and interpretation considerations refer to Section 13 2 The metrics that are available in the different NRS Quick Indicators are listed in tables 14 1 and 14 2 in Section 14 1 For metric definitions inclusion exclusion criteria and interpretation considerations refer to Section 14 2 CIHI 2015 61 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 11 In Depth NRS Comparative Reports For a list of available reports and where to find them refer to Appendix A For a list of some common terminology used in describing reports refer to Chapter 5 Attributes Metrics RCG RPG And more For a complete list of all terms used in NRS eReports refer to Appendix B 11 1 Overview Comparative Reports allow more flexibility than Quick Indicator reports but require slightly more time and effort to build at least initially They provide a comprehensive set of NRS indicators at the facility peer and national levels for the six most recent fiscal years NRS Comparative Reports are divided into four different categories 1 Admissions Profile 2 Outcomes at Discharge 3 Outcomes at Follow Up 4 Resource Utilization Each category includes up to seven different types of reports
224. turned CIHI 2015 32 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 7 Modifying and Formatting Reports This chapter describes ways in which you can modify and format your reports prior to saving exporting or printing them and describes various aspects of the report that you have now created 7 1 Report Screen After you have chosen a report to create provided answers to all required prompts and clicked on the Run Report button and after the NRS eReports system has finished querying the database and the Wait Page has disappeared a Report screen Figure 7 1 will appear Figure 7 1 An Example of the Report Screen Home ce Last update 1 16 13 9 57 29 A a O muaa maare 4 g Report Objects X REPORT DETAILS CME Report Filter Q ApplyComparison 0 gt 1 6 Discharge rita Year ID Most Recent Fiscal Year ID And Episode Type 1 Complete record with admission and discharge records 3 Complete record with a follow up And IsNotNuil Total Function Score at Admission 1D And IsNotNull Total Function Score at Discharge ID VIEW FILTER The filter is empty 1 Add Condition M Auto Apply changes O 21x PROMPT DETAILS O x PAGE BY Q Fiscal Year 2012 2013 Facility Test Facility 00001 v Facility Type General Fadlity v o 2X Data rows 13 Data columns 3 03 Average Discharge Total Function Score Across Rehabilitation Client Groups RCGs Stroke Bra
225. ty prompt rather than just one In this manner users are able to view data for several individual facilities on a single report This may be useful for instance to users who submit data to the NRS as different subdivided facilities with different facility names and numbers or to regional health authorities that wish to view all of their facilities in the same report Note Defining a Peer Group is optional to the user The Default for the Peer Group will be All Facilities as such an aggregated value for all Facilities will be displayed if no peer group is designated Example of an NRS Analytical Report The following report illustrates a sample Outcomes at Discharge Analytical Report In the example below the user has selected the desired facility and fiscal year and decided to display RCG attributes in the grid The user has also selected the Clients Discharged count Total Function Score at Admission mean and Total Function Score at Discharge mean metrics to display The user has limited the results to fiscal years 2013 2014 and 2014 2015 and Rehabilitation Client Groups to Brain Dysfunction and Stroke Figure 12 1 Sample Grid Formatted Outcomes at Discharge Analytical Report Total Total A 3 Function Function A F Facility soles hea Metrics Clients Score at Score at Discharged Admission Discharge COUNT AVG AD AVG AD a Stroke 56 73 1 96 7 POIA RO1S nenat Facity 1e3 Brain Dysfunction 14 69 8 94 8 ei
226. uch as CSV file format HTML and plain text delimiter comma tab semicolon space may also be used for a variety of purposes Note that for any of the selected format options with the exception of the HTML option a message will pop up requesting you to open save or cancel the operation CIHI 2015 48 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 To export from grid view 1 View the report in grid view 2 Click the PDF or Export icon on the Home toolbar 3 Print or save the document in exported format OR 1 View the report in grid view 2 Open the Home drop down menu 3 Select Export 4 Define Export options 5 Click Export 6 Print or save the document in exported format To export from History List 1 Navigate to the History List 2 Click the PDF or Export icon for a particular report 3 Print or save the document in exported format Exporting a Graph or Grid and Graph Report By default the report will be exported in HTML format In cases where greater manipulation of the graph and data grid is needed the Excel With Formatting option should be selected Note that if the Excel With Formatting option is selected a message will pop up requesting you to open save or cancel the operation Tip When graphing data there are times when the title representing a data element may be too long to be fully displayed in the legend of the exported graph This issue can
227. uide and Report Interpretation Guidelines April 2015 Appendix A NRS eReports Folder Structure Report Type Sub Folders at Lea w NEL Le Display Data By NRS Quick Not applicable 1 Average Days Waiting for Admission Fiscal Year Indicators Across Rehabilitation Client Groups RCGs 2 Average Admission Total Function Score Across Rehabilitation Client Groups RCGs 3 Average Discharge Total Function Score Across Rehabilitation Client Groups RCGs 4 Average Change in Total Function Score Across Rehabilitation Client Groups RCGs 5 Average Days Waiting for Discharge Across Rehabilitation Client Groups RCGs 6 Average Length of Stay LOS Across Rehabilitation Client Groups RCGs 7 Average Length of Stay LOS Efficiency Across Rehabilitation Client Groups RCGs 8 Percent Discharged Home Who Were Home Prior to Admission Across Rehabilitation Client Groups RCGs 9 Average Follow Up Total Function Score Across Rehabilitation Client Groups RCGs 10 Data Quality Indicators CIHI 2015 133 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Report Type Subfolders Reports Available Display Data By Ahi i ae 1 Admission by Referral Source Facility omparative rofile issi ilitati j Repett 2 io by Rehabilitation Client Group Fiscal Year s 3 Admission by Admission Class eae 4 Admission by Pre Hospital Living Arran
228. ular RCG to look at or a time period on which to focus for example Fiscal Year 2004 or to select the facilities with whom you want to compare Q R Readmission One of the available options for coding Admission Class in the NRS The code used for a client admitted to an inpatient rehabilitation facility or unit where the current admission is related to a prior admission for the same rehabilitation condition see Rehabilitation Client Group For example a client who received rehabilitation for a leg amputation returns to the facility a month later with a wound on the residual limb There is no time limit for length of time since the previous admission Record For the purposes of the NRS a record consists of the complete information collected on Admission Admission Record Discharge Discharge Record or Follow up Follow up Record A completed Admission and Discharge record for a client constitutes a rehabilitation episode in the NRS see Episode Referred to Facility Number A unique facility number including province number assigned by the province territory to which the person was referred at time of discharge from inpatient rehabilitation Applies only to hospitals and residential care facilities Rehabilitation Client Group RCG The condition that best describes the primary reason for the client s admission to the rehabilitation program The rehabilitation team determines the RCG at the time of admission Rehabili
229. unt for the longer average LOS for that facility For further details on these RPG methodologies please consult CIHI s Rehabilitation Patient Group RPG Grouping Methodology and Weights document available from the CIHI website at www cihi ca casemix CIHI 2015 84 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Rehabilitation Patient Groups RG and Associated RG Numeric Code RCG Codes Included in RG RPG Levels Stroke 11 1 1 1 2 1 3 1 4 1 5 1 9 1100 to 1160 Traumatic Brain Injury 12 22 221 2922 1200 to 1250 Non Traumatic Brain Injury 13 2 1 2 9 1300 to 1330 Neurological 14 3 1 3 2 3 3 3 4 3 5 3 8 3 9 1400 to 1430 4 2212 4 2221 4 2222 4 23 4 1212 4 1221 4 1222 4 13 Amputation Non Lower Extremity 17 5 1 5 2 5 9 1700 to 1710 Amputation Lower Extremity 18 5 3 5 4 5 5 5 6 5 7 1800 to 1830 Osteoarthritis 19 6 2 1900 to 1910 Rheumatoid Arthritis and 6 1 6 9 2000 to 2010 Other Arthritis 20 Pain 21 7 14 7 2 7 3 7 9 2100 to 2110 Fractures of Lower Extremity 22 8 1 8 11 8 12 8 2 8 3 2200 to 2250 Replacement of Lower Extremity 23 8 5 8 51 8 52 8 53 8 54 8 6 8 61 8 62 2300 to 2350 8 63 8 64 8 7 8 71 8 72 8 73 8 74 Other Orthopedic 24 8 9 2400 to 2440 Cardiac 25 9 1 2500 to 2540 Pulmonary 26 10 1 10 9 2600 to 2630 Burns 27 11 1 2700 Major Multiple T
230. urces are directed towards see Rehabilitation Client Group Motor Function Score FIM instrument The sum of the scores for the 13 motor elements on the FIM instrument A higher Motor Function Score suggests a higher level of independent functioning in motor activities see Motor Subscale This can be calculated on admission and on discharge where applicable Motor Subscale FIM instrument The 13 motor items of the FIM instrument Eating Grooming Bathing Dressing Upper Body Dressing Lower Body Toileting Bladder Management Bowel Management Transfers Bed Chair Wheelchair Transfers T oilet Transfers Tub or Shower Locomotion Walk Wheelchair and Locomotion Stairs N National Rehabilitation Reporting System NRS A primarily voluntary national health information system for adult inpatient rehabilitation services The province of Ontario has mandated its use for all designated rehabilitation beds in that province The NRS contains client data collected from participating adult inpatient rehabilitation facilities and programs across Canada The NRS data elements contain information related to socio demographic information administrative data health characteristics activities and participation and therapeutic interventions These elements are used to estimate a variety of indicators including wait times and client outcomes CIHI 2015 141 NRS eReports Manual User Guide and Report Interpretation Guide
231. used when this indicator is used in isolation to compare between the facility peer and national levels Cost Weight AVG This number is the average rehabilitation cost weight as determined by CIHI s RPG Case Mix Methodology and includes any adjustments to the weights due to short or long stay outliers per the methodology Non Outlier Cases Days COUNT The total number of days that individual lengths of stay exceeded the short stay trim point for a particular RPG but did not exceed the trim point that defines long stay outliers for that RPG i e were non outlier stays as described by CIHI s RPG Case Mix Methodology Non Outlier Cases Rehab Cost Weight AVG The rehabilitation cost weight for individual lengths of stay that exceeded the short stay trim point for a particular RPG but did not exceed the trim point that defines long stay outliers as defined by the Ontario Joint Policy and Planning Committee Rehabilitation Patient Group Case Mix Methodology Outlier Cases Long Stay Clients COUNT The number of clients that had individual lengths of stay that exceeded the trim point that defines long stay outliers for that RPG i e were non outlier stays as defined by CIHI s RPG Case Mix Methodology Outlier Cases Long Stay Days COUNT The total number of days that individual lengths of stay have exceeded the trim point that defines long stay outliers for a particular RPG as described by CIHI s RPG Case Mix Methodo
232. usly not available AR OD AR RU Dec 2011 Added Post Discharge Living Arrangements to the list of available attributes in discharge analytical reports AR OD Dec 2011 Added Active Rehab LOS AVG metric to resource utilization reports AR RU Dec 2011 CIHI 2015 148 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Modification Location Implementation Date Added Referral Source as an attribute AR OD Sept 2012 Added Onset Days MAX MIN AVG MEDIAN and STD DEV as a metric ARAR PAPLAN lE Added Days Waiting for Admission COUNT AVG MEDIAN 25 PERCENTILE and 75 AR AP Sept 2012 PERCENTILE metrics Removed Incomplete Episodes indicator due to complaints that the methodology was too confusing to understand More accurate QI 10 Sept 2012 information about incomplete episodes can be found in NRS quarterly RPG Reports Added LOS Efficiency MEDIAN as a metric AR OD Sept 2012 Added Primary Reason Waiting for Discharge AR OD Sept 2012 as an attribute Added Pre Admit Comorbid COUNT as a metric Added Post Admit Comorbid COUNT as a metric Added Most Responsible Health Condition ICD 10 CA Chapter as an attribute ICD 10 CA codes can be displayed by Chapter Rubric code or individual code via drilling AR AP AR OD Sept 2012 AR AP AR OD Sept 2012 AR AP AR OD Sept 2012
233. vanced Formatting window Advanced Graph Formatting Open a graph formatting window For more information about formatting refer to sections 7 3 and 7 4 7 3 Grid Formatting Grid formatting allows you to change the appearance of the objects on your report This can be done using the options available on the Grid toolbar and or Format toolbar or via the Advanced Formatting window There are three ways to access the Advanced Formatting window through the Format drop down menu by clicking on the Advanced Grid Formatting button on the Format toolbar or by right clicking on the attribute name you want to format The following four tabs appear in the Advanced Formatting window Font The Font tab allows you to select any object and object component such as header or values on the report and make changes to the font and background of the selected object Number CIHI 2015 39 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 The Number tab allows you to select any object and object component such as header or values on the report and change the number format When you select a number format such as currency date or percentage you will be presented with additional options Number options are similar to those in Microsoft Excel Alignment The Alignment tab allows you to select any object and object component such as header or values on the report and change the text alignment Options include
234. w up assessment is optional facilities can choose to submit follow up data on all clients or on only some clients or can choose to not submit any follow up data The reports in this folder provide summary data only for clients that received follow up assessments during the chosen reporting period Data is provided at the facility peer and national levels For more information about the attributes and metrics contained in these reports refer to chapters 13 and 14 respectively 1 Follow Up Living Arrangements View living arrangements for clients who received follow up during the defined reporting period 2 Follow Up Living Setting View living settings for clients who received follow up during the defined reporting period 3 Client Follow Up Count View maintenance and re hospitalization indicators for clients who received follow up during the defined reporting period Indicators include clients hospitalized since discharge clients maintaining function score gains and clients maintaining general health status 4 Functional Status at Follow Up View functional status indicators for clients who received follow up during the defined reporting period Functional status at time of admission and time of discharge are also included in this report for comparison purposes 5 Clients Achieving Partial or Full Community Reintegration View community reintegration indicators Reintegration to Normal Living Index or RNLI for clients who received follo
235. w up during the defined reporting period 11 6 Resource Utilization Comparative Reports The following section describes the contents of the Resource Utilization sub folder This folder contains seven reports 1 Rehabilitation Patient Group RPG Patient Days Report View information on patient days at the facility peer and national levels rehabilitation patient groups for the desired reporting period 2 Rehabilitation Patient Group RPG Patient Days Report Most Recently Completed Reporting Fiscal Quarter View information on patient days at the facility peer and national levels rehabilitation patient groups for the most recently completed fiscal quarter 3 Rehabilitation Patient Group RPG Case Mix Report Original Methodology View information on length of stay LOS and Case Mix Index CMI at the facility peer and national levels rehabilitation patient groups for the reporting period using the RPG cost weights and LOS trim points in effect during the fiscal year in which the client was discharged 4 Rehabilitation Patient Group RPG Case Mix Report Current Methodology CIHI 2015 66 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 View information on length of stay LOS and Case Mix Index CMI at the facility peer and national levels rehabilitation patient groups for the reporting period using the current RPG cost weights and LOS trim points This report allows for histo
236. wan in the report The attributes and direction you can drill up or down to are displayed in the menu that appears To drill using a right click 1 Display the report in grid view 2 Right click on an attribute or attribute element 3 Select drill level from the drop down menu Menu Drilling In reports that permit drilling you can access the Drill Panel by selecting Drill from the Data menu The Drill Panel allows you to drill up or down in an attribute hierarchy drill to another unrelated attribute drill from a compound metric to its underlying metrics or keep the original parent attribute on the report when you drill to a new level of detail To drill using the menu 1 Display the report in grid view 2 Open the Data drop down menu 3 Select Drill 4 Define the drill boundaries in the Drill Panel 5 Click Apply Drilling From a Graph If a Comparative Report or an Analytical Report is formatted as a graph you can drill to another level of detail by clicking directly on the graph The new graph displayed is based on the default rules the graph designer defined when constructing the report Clicking on the bar or pie piece in a graph is similar to clicking on a row or column element in a table To drill from a graph 1 Display the report in graph view 2 Click directly on the graph to drill to another level 3 Click on a bar or pie portion of the graph to drill to a more detailed data level CIHI 2015 45 NRS eRe
237. where data element Referred to Facility Number is mandatory by facility CIHI 2015 109 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 Interpretation considerations A lower rate for this indicator enhances the ability to monitor post discharge referral patterns using NRS data Unknown Health Care Number This indicator assesses the extent to which the values 50 or 70 are coded for Health Care Number which may indicate potentially missing data Although they are valid responses 50 or 70 may limit the potential usefulness of related analyses Participating facilities are encouraged by CIHI to submit health care numbers whenever possible The indicator is calculated as A B 100 expressed as a percentage where A The sum of admission records in the reporting period with 50 Not available or 70 Unknown coded for Health Care Number B The total number of admission records in the reporting period Interpretation considerations In the NRS this data element facilitates greater specificity in tracking individual records within a particular episode Monitoring the level of unknown or unavailable information for this element is important as the health care number is one of the unique client identifiers on the NRS record that allows for identification and matching of paired records CIHI 2015 110 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 U
238. will be displayed in the report header You may change the value that is selected in the Fiscal Year Page By box Figure 6 6 Example of a Grid Formatted Quick Indicator Report with Drill down Fiscal Year GROUPING Fiscal Year 2011 2012 v _ 2012 2013 10 Data Qualit i 20Mlirs Report 2011 2012 2010 2011 Facility Test Facility Si pecan E Facility Type Gener2007 2008 Facility Peer National N N N 2011 2012 Q3 Unknown Referred to Facility Number 10 161 9 0 256 8 3 Unknown Health Card Number 0 0 5 0 1 13 0 1 Unknown Date Ready for Admission 145 1 036 17 8 1 228 12 9 2011 2012 Q2 Unknown Referred to Facility Number 0 0 161 8 5 237 7 6 Unknown Health Card Number 0 0 7 0 1 16 0 2 Unknown Date Ready for Admission 41 937 16 3 1 169 12 6 CIHI 2015 26 NRS eReports Manual User Guide and Report Interpretation Guidelines April 2015 6 3 Creating NRS Comparative Reports To create a Comparative Report 1 From either the NRS eReports Launch Page Chapter 3 or the NRS eReports folder Section 6 1 click on NRS Comparative Reports Figure 6 7 NRS Comparative Reports can be accessed from the NRS eReports folder fine gt NRS eReports p Ge a 1 NRS Quick Indicators Owner Administrator Modified 7 14 09 7 16 30 AM View at a glance reports of several Admission Discharge and Follow up Indicators for each Rehabilitation Client Group at the Facility Peer and National levels for
239. y List are specific to your profile and are not accessible to other users Reports listed in this folder may be quickly viewed printed and or exported The History List also displays messages about reports that you have created or are in the process of creating provided that they have been explicitly added to the History List Each message shows the status of a report and other identifying information such as the report name and the date and time at which the report was created NRS eReports stores reports in a cache allowing for their quick retrieval from the History List Reports do not remain in the History List indefinitely The number of reports that each user can have in the History List and the length of time that they remain there are controlled by the CIHI administrator What Can I Do With Reports in the History List The main History List page displays a list of all reports currently available for interaction The reports are presented in a table with four column headings Name The Name column lists the report name as a hyperlink to the report data If the report was executed successfully clicking on this link will open the report so that you may interact with the data If the report did not execute an error message will be displayed Status The Status column indicates whether the report was executed successfully or not Ready means the report is ready for viewing Error means an error occurred during the execution

NRS eReports Manual: User Guide & Report Interpretation

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NRS eReports Manual: User Guide &amp; Report Interpretation

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NRS eReports Manual: User Guide & Report Interpretation