The e-Scorecard is a web-enabled application that runs on servers managed by the Hospital Report Research Collaborative. Authorized users use Internet Explorer to access the application. The e-Scorecard is owned by the Hospital Report Research Collaborative, and was developed using the Metrics3d platform sold by ABS Systems Consultants Ltd.

The e-Scorecard is a management tool available for use by hospitals who participate in our research program. If you are a participating hospital, learn more about accessing the e-Scorecard. Our public reports are available for download by any interested reader and contain aggregated summaries of data found in our e-Scorecard.

The e-Scorecard has an intuitive, user-friendly interface. A basic familiarity with Internet Explorer is all that is required to navigate through the application. New users will find it helpful to review the checklist of assumptions to learn about system requirements. A user guide can also be downloaded. Understanding how indicator values are calculated, and interpreting indicator values, requires expertise. To make effective use of the e-Scorecard, hospitals must have access to this expertise.

The framework for performance measurement and benchmarking in this system is a credible and progressive management tool that will allow users to align their strategic directions with measurable outcomes, monitor achievement of their strategic objectives, and make decisions with respect to allocation of resources to improve patient care.

This system is a "performance exploration" tool designed to highlight trends and opportunities at a high level and to identify hospitals that might have employed potential best practices. You will be able to download data from the e-Scorecard to the statistical package of your choice, should you wish to do more advanced analysis.
Specifically, the e-Scorecard offers a number of analysis and reporting options that will be helpful when you are:

• Monitoring and reporting on your performance
• Comparing your performance with the performance of other hospitals
• Researching and/or investigating service-related performance issues
• Reviewing trends in service delivery
• Preparing periodic reports and presentations

There are several benefits to the e-Scorecard:

• Applies an intuitive colour scheme to immediately draw your attention to areas of interest and to prompt you to look at your own information and practices further determine whether there is an area you want to explore further. Three colours are used to give an immediate contextual sense of your performance: yellow means that your organization's performance score meets the target threshold, green means the score is above the target threshold and red means that the score is below the target threshold.
• Offers something for everyone - from simple, information-rich performance summary reports and graphs that will appeal to the senior management - to more advanced techniques that can be used by analysts within your hospital.
• Provides organisational performance summary reports and graphs that can be easily drilled down to the underlying details to help support specific action steps.
• Summarizes results into a dashboard and other graphic displays for hospitals, using colours to reflect relative performance, and tabulated reports that include the hospital's scores and underlying components to support comparisons across hospitals.
• Allows for saving, printing, graphing and emailing option for ease of sharing information.

The colours in the report are based on the default Hospital Report (HRRC) Target, which for the 2008 e-Scorecard, is also the provincial average.

Absolutely. One of the e-Scorecard's key advantages is the ability to look at comparative information across participating hospitals by customizing comparator groups, regions and the province as a whole. Further, you can also retrieve demographic information on another hospital such as address, main phone number, and website (where available).

No, you are only limited to the number of users decided by your organisation for authorized use of the e-Scorecard.

Yes. Any of your generated reports can be e-mailed or alternatively be saved by you for subsequent processing. Please see the chapter on Downloading and E-mailing Reports for details in the User Manual.

Differentiating Factors	e-Scorecard	WHIC
Application Type	Web-based, stand-alone, password-protected, multidimensional application	Shell application to be downloaded into a local PC with Base SAS software
Key Objective	Comparative analysis using annually-calculated Hospital Report indicators and components	Real-time calculation of a hospital's clinical and financial indicators
Target Users	Hospital staff with a decision support/quality improvement/data analysis portfolio	Board members, senior executives, quality improvement directors, decision support analysts

Quadrant	Number of indicators	Indicators
Clinical Utilization and Outcomes	7	Readmissions - all medical patients, Readmissions - specific medical conditions, Readmissions - specific surgical procedures, Adverse Events - nurse-sensitive medical, Adverse Events - nurse-sensitive surgical, Adverse Events - all medical conditions, and Appropriateness - cholecystectomy
Financial Performance and Condition	9	Total Margin, Current Ratio, Debt Service Coverage, % Equipment Expense, Unit Cost Performance, % Corporate Services, % Sick Time, Inpatient Nursing Productivity, and % Registered Nurse Hours
Patient Satisfaction	4	Overall impressions, Communication, Consideration, and Responsiveness
System Integration and Change	10	All indicators
Women's Health	5	Route of Hysterectomy, Adverse Events - gyne procedures, Adverse Events - labour and delivery, Readmissions - gyne procedures, Readmissions - labour and delivery

Fourteen new indicators have been added, modified, or updated since the last release in the Hospital Report series (10 new indicators for the Acute Care sector; 4 new indicators for the Emergency Department Care sector). In addition, several indicators have been modified and undergone methodological refinements. Please see the technical summaries for more information. Because the methodology used to calculate indicators is reviewed annually, and in some cases, changes are made to improve methodology over time, it is also important to exercise caution when examining year-to-year changes in indicator values. Click here for more information.

Most of the definitions for the indicators in the e-Scorecard appear on the Meta Data screen. Please click here for any 2007 definitions in the emergency department care sector -clinical utilization and outcomes quadrant and complex continuing care sector - patient and family satisfaction quadrant that are not currently showing. These will appear soon.

Contact information for questions related to how specific indicators are calculated is included in the metadata within the e-Scorecard application. After drilling down to a specific indicator, click on the indicator name of interest. Then select Measure Definition under Information from the panel on the left side of the screen. This choice does not become available until you have selected an indicator by clicking on its value. Contact information will appear under the Definition for the indicator. Other information with respect to the methodology can be found in the Technical Reports/Summaries.

The e-Scorecard help button contains information on: Downloading Reports to Your Local Computer, Printing Reports, and Saving and Retrieving Reports.

The Sector Reports in the Standard Executive Reports tab is currently under construction and are not viewable. Reports are available in the link Download A Report.

The range on the top of a gauge defines the confidence interval. The range at the bottom of the gauge shows the range of values for all hospitals for that point in time.

The colour of the gauge is defined by the overlap of the Confidence Interval and Target Thresholds.

Performance allocation methodology is different for each quadrant; click here for details for the Acute Care 2006 performance allocation. Please refer to the Technical Summary documents for the Hospital Reports for information on the methods used to determine performance allocation.

To get the best image when printing a report from the e-Scorecard you should export the results to a word or excel file. The print/export function is not available under Performance Snapshot screen. If you wish to print data that appears in the Performance Snapshot screen go to Create Your Own Reports > Comparative Analysis > Compare Measures tab. The Export button is on the top right hand of the screen. For more help see Get Documentation.

Some hospital-specific indicator results are not shown because of data suppression a) for patient/physician confidentiality; b) data quality/coding reasons; c) missing date / no survey; and d) insufficient sample size.

By default, Print background colors and images option is turned off in Internet Explorer (browser). For this reason, you will not be able to print background colour of the Web page. To resolve this behaviour, turn on the Print background colors and images option in Internet Explorer by following these steps:

• On the Tools menu, click Internet Options, and then click the Advanced tab.
• In the Settings box, scroll down to Printing and click to select the Print background colors and image check box, and then click Apply and OK.

Note: Turn off this option after printing. Otherwise, any other pages that you print from Internet Explorer will have the background color printed.

For general questions, please e-mail us at: escorecard[at]uwaterloo[dot]ca

General questions about the e-Scorecard can be directed to the Information Management team for the Health System Performance Research Network (HSPRN) at 519-888-4620 and/or at escorecard[at]uwaterloo[dot]ca.

General questions about the data for the Acute Care, Complex Continuing Care, Emergency Department Care, and Rehabilitation sectors can be directed to the Hospital Report team at the Canadian Institute for Health Information (CIHI) at 416-544-5344 and/or at hospitalreport[at]cihi[dot]ca.

General questions about the data for the Mental Health sector can be directed to the Hospital Report: Mental Health project leads: Elizabeth Lin at 416-535-8501 ext. 4102 and/or at elizabeth_lin[at]camh[dot]net, Janet Durbin at 416-535-8501 ext. 6229 and/or at janet_durbin[at]camh[dot]net.