Canadian Health Outcomes for Better Information
(C-HOBIC)
Although the Canadian Health Outcomes for Better Information (C-HOBIC) is not an American Nurses Association recognized terminology, it is endorsed by the Canadian Nurses Association and the Canadian Nursing Informatics Association. The focus, as implied in the name, is on outcomes. It is intended to “capture patient outcome data related to nursing care across four sectors of the health system: acute care, complex continuing care, long-term care and home care.” Each of the outcomes has a definition, and a valid and reliable measure. They are supported by empirical evidence that links them to nursing inputs or interventions.
Its origins can be traced to the 1999 Ontario Ministry of Health and Long-Term Care Nursing and Health Outcomes Project.3 C-HOBIC addresses nursing sensitive outcomes such as functional status, symptom management, and safety outcomes, for acute care, home care, long term, and complex continuing care as well as therapeutic self-care for acute and home care.4 The emphasis is on “…empirical evidence that nursing/health care providers impact patient care (outcomes).4 C-HOBIC provides a consistent electronic data collection at the point of care that allows “real-time feedback of information that clinicians can use in planning and evaluating care.4 It is intended to be integrated with existing assessments to avoid duplication.
The work was divided into two phases. Phase 1 began in May 2007 and was successfully completed in December 2009.5 Data was collected in Ontario, Saskatchewan, and Manitoba using a web-based survey, focus group sessions, and key stakeholder interviews. Elements evaluated were:
- The value of C-HOBIC information to nurses
- Integrating C-HOBIC into nurses’ workflow
- Manager and policy makers use of aggregated information.
“The successful completion of Phase 1 of the C-HOBIC Project marked the first time in Canada that standardized clinical information reflective of nursing practice was collected and made available to clinicians.”5
Phase 1 also included a consultant who mapped the C-HOBIC concepts to the ICNP®. The final outcome was an ICNP catalogue the Nursing Outcome Indicators Catalogue.”5
“the extension of the collection of the C-HOBIC measures into acute care in the Winnipeg Health Region (WHR) and the development, implementation and evaluation of a new mechanism for using C-HOBIC data to facilitate patient transition from one sector of the health care delivery system to another, i.e. among acute care, long term care and home care.”
Phase 2 is scheduled to be complete in 2014. In this phase, the collection of the C-HOBIC data was extended into the Winnipeg health region5 as well as continued collection in Ontario and Manitoba.6 In this phase reports using C-HOBIC data will be developed to facilitate the movement of patients from one sector of the health care delivery to another. These reports will use synoptic reporting principles. Structured synoptic reporting utilizes electronic data entry from structured, discrete fields.7 Templates are used to guide the entry of clinician data with the result that clinicians can complete reports in less time. Phase 2 also examined the use and user satisfaction with C-HOBIC at the point of care and the synoptic reports between agencies.
References
1 About C-HOBIC. [cited; Available from: http://c-hobic.cna-aiic.ca/about/default_e.aspx
2 C-HOBIC FAQs. Available from: http://c-hobic.cna-aiic.ca/documents/pdf/C-HOBIC_FAQs_Feb2013_e.pdf
3 VanDeVelde-Coke S, Doran D, Grinspun D, et al. Measuring Outcomes of Nursing Care, Improving the Health of Canadians: Nurs Leadersh. 2012;25(2):26-37.
4 Canadian Outcomes for Better Information and Care (C-HOBIC). 2014 ; Available from: https://www.infoway-inforoute.ca/index.php/programs-services/standards-collaborative/pan-canadian-standards/canadian-outcomes-for-better-information-and-care-c-hobic
5 Hannah K, White PA, Kennedy MA, Hammell N. C-HOBIC – Standardized Information to Support Clinical Practice and Quality Patient Care across Canada
NI 2012; 2012 June 23-27; Montreal, Quebec Canada; 2012.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799147/
6 Nagle LM, White P. Advancing the Uptake and Perceived Value of Standardized Clinical Data. 2014 June 2; Available from: http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=
web&cd=6&cad=rja&uact=8&ved=0CDkQFjAF&url=http%3A%2
F%2Fwww.e-healthconference.com%2Fcfm%2Findex.cfm%3
FAF%3DDownload%26AA%3D202%2C971%26AD%3DDl
File&ei=cMgNVJ_dAsyWyATVmIHwAw&usg=AFQjCNE6OtZd
6zqLqy13htpMdCfFvoaAdQ&sig2=LkuUSuK5eCCmhL5gm
NVyZg&bvm=bv.74649129,d.aWw
7 Edlund T. What is Synoptic Reporting? 2014 January 6 ; Available from: http://www.softworksgroup.com/blog/what-is-synoptic-reporting
Additional Resources
Links to information about C-HOBIC
Contains links to a summary of the work of Phase 1 and Phase 2 of the Canadian Nursing and Health Outcomes Project. Unfortunately, the links from HOBIC measures do not work, however, items on the drop-down menu for Implenting HOBIC and Resources do work.
Hannah KJ, White PA, Nagle LM, Pringle DM. Standardizing nursing information in Canada for inclusion in electronic health records: C-HOBIC. Journal of the American Medical Informatics Association. 2009 Jul-Aug;16(4):524-30.
Report about the implementation of C-HOBIC in three Canadian Provinces.
Created September 9, 2014
