FOOTNOTES AND LEGEND

MLPA PERFORMANCE INDICATORS NOV, 2011 FOOTNOTES AND LEGEND NB Colour coding for 2010/11 has been updated to match the methodology being used for 2011/12, so may not match colour coding released previously * Indicator also has a provincial interim goal of 25 hours ** Indicator also has a provincial interim goal of 7 hours Notes (Refers to 14-Nov-11 data only) 1 Q2 2011/12 Data (Jul, Aug, Sep 2011 Data) 2 Q1 2011/12 Data (Apr, May, Jun 2011 Data) 3 Q4 2010/11 (Jan, Feb, Mar 2011 Data) Colour Legends Release dates: 13-May-11 DOING WELL: The result is less than or equal to its target MONITORING NEEDED:The result is 1) greater than its target AND 2) within 10% of its target AT RISK, ACTION REQUIRED: The result is greater than 10% above its target Release dates: 11-Feb-11, 12-Aug-11, 14-Nov-11 DOING WELL: The result is less than or equal to its target MONITORING NEEDED, IMPROVING: The result is 1) greater than its target AND 2) less than its baseline or less than a 10% corridor above its target (whichever is higher) AND 2) has improved since the last quarter MONITORING NEEDED, NOT IMPROVING: The result is 1) greater than its target AND 2) less than its baseline or less than a 10% corridor above its target (whichever is higher) AND 2) has not improved since the last quarter AT RISK, ACTION REQUIRED: The result is 1) greater than 10% above its target AND 2) greater than its baseline

Percentage of Alternate Level of Care (ALC) Days - By of Institution 2 2010/11 2011/12 Erie St Clair 10.85% 9.00% 13.28% 14.51% 13.24% 12.00% 18.94% 11.27% South West 11.59% 8.80% 10.24% 10.32% 10.67% 8.80% 13.55% 11.90% Waterloo Wellington 17.64% 12.51% 18.56% 16.98% 16.88% 9.46% 18.11% 14.52% Hamilton Niagara Haldimand Brant 20.97% 11.00% 19.30% 17.82% 17.88% 11.00% 17.94% 12.94% Central West 10.13% 9.50% 9.26% 7.96% 9.55% 9.46% 9.89% 8.67% Mississauga Halton 9.21% 8.30% 10.03% 9.29% 9.73% 9.21% 12.23% 8.52% Toronto Central 11.20% 8.40% 10.08% 10.49% 10.78% 10.00% 11.01% 10.27% Central 15.43% 13.01% 16.53% 16.59% 16.10% 13.01% 15.04% 14.53% Central East 18.41% 12.20% 18.90% 21.29% 20.22% 14.80% 18.39% 16.95% South East 16.83% 10.10% 15.29% 14.99% 14.78% 9.46% 13.19% 10.35% Champlain 15.65% 12.80% 16.32% 18.33% 16.09% 13.50% 16.25% 14.37% North Simcoe Muskoka 19.82% 15.40% 19.77% 18.40% 19.40% 15.40% 18.51% 18.58% North East 27.99% 17.00% 34.11% 31.05% 33.22% 17.00% 40.76% 32.89% North West 17.86% 15.40% 21.54% 22.67% 21.76% 15.40% 21.31% 17.44% ONTARIO 15.90% 9.46% 16.40% 16.31% 16.70% 9.46% 17.50% 14.40%

90th Percentile ER Length of Stay for Admitted Patients* 1 2010/11 2011/12 Low Erie St Clair 18.50 17.00 24.82 24.23 23.32 17.00 24.22 22.92 South West 25.40 25.00 26.75 30.43 26.42 23.75 28.75 24.05 Waterloo Wellington 25.50 20.00 31.30 30.18 29.32 20.00 28.25 27.88 Hamilton Niagara Haldimand Brant 35.50 28.30 36.78 42.12 38.92 28.30 34.60 31.08 Central West 35.00 27.20 32.72 36.93 30.63 26.50 33.62 35.82 Mississauga Halton 38.60 28.40 35.95 42.37 35.87 23.00 35.02 32.73 Toronto Central 30.20 25.00 27.10 29.38 27.72 23.00 24.95 24.75 Central 40.60 36.00 43.63 49.78 44.28 36.00 41.28 34.95 Central East 48.00 39.00 53.27 53.33 51.62 39.00 43.60 42.82 South East 26.70 25.00 27.05 26.97 26.82 22.90 24.22 27.08 Champlain 29.60 28.00 31.50 32.55 32.45 26.50 29.30 28.52 North Simcoe Muskoka 24.30 24.00 23.85 24.58 23.23 23.00 21.58 24.27 North East 21.80 20.70 28.75 29.05 28.43 23.50 27.75 23.38 North West 27.20 25.00 29.78 31.55 28.83 25.00 29.82 28.82 ONTARIO 31.1 8 hours 32.15 35.77 32.15 8 hours 30.42 28.85

90th Percentile ER Length of Stay for Non-Admitted Complex (CTAS I-III) Patients** 1 2010/11 2011/12 Low Erie St Clair 6.80 6.50 6.98 7.17 7.13 6.50 7.32 7.23 South West 6.30 6.30 6.48 6.60 6.45 6.30 6.25 6.42 Waterloo Wellington 7.20 6.80 7.50 7.83 7.52 6.80 7.60 7.73 Hamilton Niagara Haldimand Brant 8.10 7.50 7.93 7.77 7.87 7.50 7.78 7.73 Central West 9.50 8.40 8.77 8.50 8.72 8.40 8.27 7.98 Mississauga Halton 7.20 7.00 6.75 6.82 6.70 6.70 6.55 6.37 Toronto Central 9.50 8.30 8.08 8.13 8.20 8.00 8.12 8.05 Central 8.70 7.90 7.80 7.93 7.83 7.83 7.68 7.25 Central East 8.00 7.60 7.08 7.27 7.40 7.00 6.92 6.82 South East 7.00 6.80 6.75 6.82 6.88 6.80 6.83 7.10 Champlain 8.70 8.00 8.65 8.67 8.58 8.00 8.63 8.40 North Simcoe Muskoka 6.90 6.80 6.87 6.80 6.90 6.80 6.32 6.63 North East 6.90 6.50 6.87 7.88 7.20 6.50 7.57 7.42 North West 6.60 6.60 6.70 6.82 6.62 6.50 6.58 6.75 ONTARIO 7.9 8 hours 7.52 7.62 7.9 8 hours 7.47 7.37

Low 90th Percentile ER Length of Stay for Non-Admitted Minor Uncomplicated (CTAS IV-V) Patients 1 2010/11 2011/12 Erie St Clair 4.30 4.00 4.15 4.25 4.32 4.00 4.30 4.38 South West 4.00 4.00 3.82 3.92 3.88 4.00 3.67 3.88 Waterloo Wellington 5.30 4.10 4.78 5.40 5.12 4.10 5.12 4.88 Hamilton Niagara Haldimand Brant 5.10 4.50 4.72 4.95 4.82 4.50 4.98 4.83 Central West 5.00 4.00 4.03 4.05 4.23 4.00 3.85 3.87 Mississauga Halton 4.10 4.00 3.70 3.70 3.70 3.70 3.85 3.67 Toronto Central 5.80 5.00 5.05 5.32 5.12 4.50 4.93 4.82 Central 4.30 4.20 3.87 3.97 3.90 3.90 3.80 3.62 Central East 5.10 4.80 4.27 4.65 4.50 4.00 4.42 4.30 South East 4.20 4.00 4.05 4.03 4.02 4.00 4.15 4.43 Champlain 5.30 4.80 5.00 5.30 5.15 4.80 5.08 5.00 North Simcoe Muskoka 4.20 4.00 3.85 4.03 4.00 4.00 3.83 4.08 North East 4.30 4.00 4.13 4.35 4.25 4.00 4.38 4.25 North West 4.10 4.00 4.07 4.18 4.12 4.00 3.92 4.08 ONTARIO 4.7 4 hours 4.27 4.50 4.7 4 hours 4.35 4.32

90th Percentile Wait Times for Diagnostic MRI Scan 1 2010/11 2011/12 Erie St Clair 70 28 55 58 59 28 42 57 South West 107 81 67 67 67 44 53 70 Waterloo Wellington 82 28 69 64 62 28 65 58 Hamilton Niagara Haldimand Brant 100 95 126 117 119 88 95 95 Central West 110 94 131 111 130 82 88 77 Mississauga Halton 121 121 147 141 143 97 103 84 Toronto Central 122 115 135 122 132 115 102 96 Central 136 112 131 127 147 112 122 109 Central East 107 77 111 80 102 63 74 89 South East 95 72 103 98 94 72 70 90 Champlain 129 97 102 116 105 85 110 124 North Simcoe Muskoka 109 93 96 107 105 90 104 115 North East 88 69 112 122 105 80 125 117 North West 43 28 69 86 66 59 61 77 ONTARIO 110 28 days 121 109 116 28 days 93 94

90th Percentile Wait Times for Diagnostic CT Scan 1 2010/11 2011/12 Erie St Clair 26 26 28 27 28 26 27 27 South West 34 28 24 28 29 25 26 27 Waterloo Wellington 33 28 26 27 28 28 27 28 Hamilton Niagara Haldimand Brant 49 43 41 46 43 43 44 48 Central West 31 28 14 21 21 25 25 21 Mississauga Halton 38 35 22 38 27 27 42 40 Toronto Central 38 35 33 35 33 28 37 38 Central 44 38 40 30 37 34 28 35 Central East 41 36 25 28 28 28 25 24 South East 27 27 17 20 22 22 21 21 Champlain 108 90 34 42 49 42 44 48 North Simcoe Muskoka 41 39 32 28 30 28 25 28 North East 29 29 31 30 33 33 35 30 North West 28 28 24 25 25 28 25 35 ONTARIO 42 28 days 30 33 33 28 days 33 35

90th Percentile Wait Times for Hip Replacement 1 2010/11 2011/12 Erie St Clair 132 132 127 148 121 121 135 185 South West 151 151 176 221 186 178 209 212 Waterloo Wellington 103 103 129 108 120 103 122 141 Hamilton Niagara Haldimand Brant 177 177 222 216 201 177 218 214 Central West 156 156 170 176 171 171 167 160 Mississauga Halton 138 138 148 141 144 138 167 155 Toronto Central 123 135 125 129 124 135 138 146 Central 139 139 158 150 150 139 140 151 Central East 173 179 200 169 190 179 179 170 South East 146 146 151 124 141 141 121 116 Champlain 293 222 309 295 295 250 293 290 North Simcoe Muskoka 208 182 272 161 243 182 143 122 North East 386 300 301 302 301 215 336 245 North West 211 182 173 171 176 176 173 167 ONTARIO 161 182 195 185 181 182 187 184

90th Percentile Wait Times for Knee Replacement 1 2010/11 2011/12 Erie St Clair 142 142 124 122 130 130 137 145 South West 166 166 200 209 198 182 256 246 Waterloo Wellington 115 115 181 169 169 115 202 206 Hamilton Niagara Haldimand Brant 209 182 217 231 217 182 261 227 Central West 161 161 172 190 185 175 199 187 Mississauga Halton 159 159 156 164 156 156 183 217 Toronto Central 129 140 130 150 125 140 162 165 Central 154 154 161 167 162 154 184 158 Central East 171 179 220 166 187 179 177 156 South East 148 148 153 131 145 145 133 127 Champlain 247 182 252 254 242 200 291 274 North Simcoe Muskoka 230 182 244 187 235 182 125 135 North East 382 300 409 414 426 300 364 472 North West 246 182 166 183 187 182 207 216 ONTARIO 181 182 203 199 197 182 223 215

90th Percentile Wait Times for Cancer Surgery 1 2010/11 2011/12 Erie St Clair 48 48 44 45 45 45 43 40 South West 91 80 86 104 93 80 83 90 Waterloo Wellington 49 49 53 49 49 49 51 43 Hamilton Niagara Haldimand Brant 58 58 60 65 61 58 57 57 Central West 57 57 69 59 61 57 48 57 Mississauga Halton 60 60 57 63 57 57 62 46 Toronto Central 66 66 61 64 65 70 59 64 Central 47 47 41 41 46 47 41 43 Central East 49 49 47 45 48 49 47 52 South East 51 51 48 58 51 51 54 49 Champlain 63 63 54 64 60 60 61 65 North Simcoe Muskoka 55 55 63 62 61 55 55 65 North East 51 48 54 63 62 48 68 61 North West 40 45 34 37 39 45 36 41 ONTARIO 60 84 days 57 61 60 84 days 56 59

90th Percentile Wait Times for Cardiac By-Pass Procedures 1 2010/11 2011/12 South West 55 55 38 46 49 49 49 41 Waterloo Wellington 29 34 28 24 34 34 23 23 Hamilton Niagara Haldimand Brant 48 48 32 43 34 48 42 55 Mississauga Halton 37 37 28 35 34 34 44 48 Toronto Central 44 44 43 59 48 44 51 50 Central 63 63 58 61 64 63 64 63 South East 64 64 85 35 51 51 46 57 Champlain 76 76 51 56 63 63 51 46 North East 49 49 49 28 62 49 41 32 ONTARIO 54 182 days 45 50 49 182 days 49 51

90th Percentile Wait Times for Cataract Surgery 1 2010/11 2011/12 Erie St Clair 56 56 64 64 64 56 52 76 South West 85 85 89 99 93 85 87 98 Waterloo Wellington 76 76 104 96 92 92 88 123 Hamilton Niagara Haldimand Brant 104 104 139 129 127 120 129 139 Central West 90 90 116 104 99 90 100 155 Mississauga Halton 96 96 160 177 155 96 198 177 Toronto Central 100 100 114 114 106 100 104 120 Central 102 102 96 89 102 102 76 87 Central East 127 140 167 111 153 140 111 124 South East 97 97 109 118 112 97 126 112 Champlain 133 150 160 146 154 150 149 150 North Simcoe Muskoka 117 133 151 132 133 133 161 172 North East 115 115 133 141 125 125 141 160 North West 106 106 90 86 103 112 139 103 ONTARIO 108 182 days 131 118 123 182 days 117 125

Readmission within 30 Days for Selected CMGs 3 2010/11 2011/12 Erie St Clair 15.00% 12.80% 16.20% 14.77% 15.51% 12.80% 16.01% 15.02% South West 16.00% 14.20% 15.41% 16.28% 15.84% 14.00% 16.73% 13.19% Waterloo Wellington 14.40% 14.00% 13.64% 16.09% 14.81% 14.00% 13.37% 12.13% Hamilton Niagara Haldimand Brant 15.10% 14.00% 15.17% 15.03% 15.10% 14.00% 15.71% 15.18% Central West 15.20% 14.70% 15.44% 14.93% 15.19% 14.70% 14.80% 15.33% Mississauga Halton 13.10% 13.10% 12.60% 13.97% 13.34% 12.60% 12.87% 13.05% Toronto Central 16.20% 15.20% 18.70% 19.60% 19.17% 18.00% 19.07% 17.76% Central 15.20% 14.40% 14.74% 15.57% 15.19% 14.40% 15.23% 15.05% Central East 15.50% 15.30% 15.17% 14.21% 14.77% 14.50% 15.77% 15.17% South East 15.20% 14.30% 15.03% 15.56% 15.36% 14.30% 14.83% 16.57% Champlain 15.50% 14.00% 16.14% 16.38% 16.34% 14.50% 15.76% 15.73% North Simcoe Muskoka 15.50% 14.50% 14.13% 16.97% 15.53% 14.20% 15.34% 14.80% North East 16.60% 14.40% 16.30% 17.43% 16.99% 14.40% 16.22% 15.45% North West 15.80% 14.80% 16.10% 19.05% 17.58% 16.00% 18.04% 15.63% ONTARIO 15.3 TBD 15.53% 16.16% 15.83% TBD 15.88% 15.14%

Repeat Unscheduled Emergency Visits within 30 Days for Mental Health Conditions 3 2010/11 2011/12 Erie St Clair 14.50% 12.50% 17.09% 15.75% 19.80% 18.80% 17.82% 17.70% South West 14.80% 12.50% 15.63% 13.98% 15.50% 14.70% 15.21% 14.80% Waterloo Wellington 13.70% 11.60% 13.16% 15.52% 14.80% 13.20% 15.41% 16.28% Hamilton Niagara Haldimand Brant 17.10% 15.40% 17.90% 15.98% 18.40% 18.40% 19.47% 20.01% Central West 14.20% 12.10% 15.86% 13.01% 15.30% 14.84% 15.54% 14.21% Mississauga Halton 14.90% 12.60% 14.59% 13.80% 15.50% 14.70% 12.46% 15.84% Toronto Central 25.80% 23.22% 26.32% 25.58% 25.80% 25.00% 23.43% 23.90% Central 16.10% 13.60% 19.12% 16.91% 17.90% 17.00% 17.98% 14.45% Central East 15.20% 13.00% 15.68% 17.72% 17.50% 16.60% 17.75% 18.68% South East 15.40% 13.10% 14.15% 15.53% 16.80% 16.00% 19.57% 20.85% Champlain 12.50% 12.50% 13.75% 13.91% 17.10% 17.10% 16.24% 17.27% North Simcoe Muskoka 14.10% 14.00% 11.55% 14.33% 13.60% 13.60% 14.47% 12.45% North East 16.00% 14.80% 17.51% 18.99% 19.10% 18.10% 19.70% 18.33% North West 16.50% 13.70% 15.33% 19.14% 19.30% 17.40% 21.15% 18.06% ONTARIO 16.85 TBD 17.39% 17.48% 17.50% TBD 18.40% 18.15%

Repeat Unscheduled Emergency Visits within 30 Days for Substance Abuse Conditions 3 2010/11 2011/12 Erie St Clair 19.00% 16.10% 20.03% 18.18% 19.20% 17.20% 19.29% 26.51% South West 22.70% 19.00% 31.42% 25.48% 26.30% 25.00% 26.21% 23.17% Waterloo Wellington 19.70% 16.80% 24.92% 21.36% 21.80% 18.75% 19.29% 16.91% Hamilton Niagara Haldimand Brant 19.00% 17.10% 22.59% 20.34% 21.40% 21.40% 20.66% 20.77% Central West 17.00% 14.50% 18.84% 20.39% 18.40% 17.90% 17.89% 17.67% Mississauga Halton 20.40% 17.40% 19.23% 20.06% 19.50% 18.50% 17.63% 19.81% Toronto Central 35.00% 32.00% 38.22% 39.49% 37.40% 35.00% 36.61% 37.31% Central 16.50% 16.50% 23.72% 22.17% 20.70% 19.70% 18.41% 16.50% Central East 20.60% 17.50% 17.28% 19.79% 19.60% 19.00% 20.59% 22.98% South East 14.30% 14.30% 25.13% 20.70% 20.90% 19.90% 12.47% 15.96% Champlain 20.90% 18.80% 26.75% 24.25% 25.90% 25.90% 19.93% 23.98% North Simcoe Muskoka 14.70% 14.70% 12.87% 12.64% 15.60% 14.00% 18.84% 16.57% North East 20.60% 19.00% 24.92% 29.20% 30.00% 27.00% 24.34% 26.24% North West 29.70% 22.20% 33.50% 29.47% 32.30% 29.10% 25.39% 31.72% ONTARIO 25.67 TBD 28.06% 27.06% 27.60% TBD 25.20% 27.00%

90th Percentile Wait Time for CCAC In-Home Services - Application from Community Setting to first CCAC Service (excluding case management) 2 2010/11 2011/12 Erie St Clair NA NA 14.00 14.00 23.00 23.00 25.00 21.00 South West NA NA 29.00 28.00 28.00 26.60 29.00 27.00 Waterloo Wellington NA NA 29.00 28.00 36.00 34.20 27.00 23.00 Hamilton Niagara Haldimand Brant NA NA 26.00 25.00 32.00 27.00 54.00 25.00 Central West NA NA 16.00 16.00 19.00 19.00 19.00 21.00 Mississauga Halton NA NA 17.00 14.00 33.00 31.40 19.00 24.00 Toronto Central NA NA 36.00 30.00 33.00 31.40 28.00 32.00 Central NA NA 21.00 27.00 39.00 37.10 29.00 25.00 Central East NA NA 34.00 31.00 42.00 39.90 92.00 47.00 South East NA NA 27.00 26.00 28.00 26.60 23.00 23.00 Champlain NA NA 59.00 48.00 69.00 62.10 52.00 47.00 North Simcoe Muskoka NA NA 43.00 71.00 75.00 67.50 98.00 46.00 North East NA NA 41.00 50.00 73.00 65.70 70.00 44.00 North West NA NA 21.00 17.00 37.00 35.20 29.00 30.00 ONTARIO 35 TBD 28.00 27.00 27 TBD 40.00 31.00

MLPA Final PI X s_(nov 14, 2011 Accountability Agreement Performance Indicator Notes Low This page provides detail for a performance indicator listed in Schedule 10 of the 2011-2012 Performance Agreement. Notes below should align with descriptive sheets in the document: MOHLTC- Performance Agreement, Local Health System Performance Indicators Technical Information () Performance Indicator: Wait Times for Cancer Surgery Description: 90 th Percentile Wait Times for Cancer Surgery Indicator calculation: Step 1: Wait Days = Procedure Date Decision to Treat Date Patient Unavailable Days Step 2: Sort the records ascending. Patients with short wait days on top and patients with long wait days at the bottom. Step 3: Count the total number of cases and multiply by 0.90 (let s call this the 90 th obs ). If this value has a decimal digit greater than zero then roundup. The 90 th percentile wait time is the wait time of the 90 th obs patient. The 90 th percentile value is not interpolated. Numerator: N/A Denominator: N/A Inclusion and exclusion criteria: 1. Wait Time is calculated based on closed cases submitted by hospitals through the Wait Time Information System. 2. All closed wait list entries with procedure dates within date range 3. Must be 18 and older on the day the procedure was completed 4. Procedures No Longer Required are excluded from wait time calculation 5. Includes treatment cancer procedures only. Procedures classified as "NA" are currently included. Diagnostic, palliative and reconstructive cancer procedures are excluded. Procedures on skin - carcinoma, skin-melanoma, and lymphomas are also excluded. 6. Procedures assigned as priority level 1 are excluded from wait time calculation. 7. Wait list entries identified by hospitals as data entry errors are also excluded. 8. If unavailable days fall outside the decision to treat date up to procedure date, unavailable days are not deducted from patients wait days. These are considered data entry errors. Data Source: Cancer Care Ontario (Access to Care Informatics, 2011). MOHLTC\HSIMI\HA and HD Final

MLPA Final PI X s_(nov 14, 2011 Low Performance Indicator: Wait Times for Cardiac By-Pass Surgery Description: 90 th Percentile Wait Times for Cardiac By-Pass Surgery Waiting periods are counted from the date a patient was accepted for bypass surgery by the cardiac service or cardiac surgeon. Waiting periods do not include time spent investigating heart disease before a patient is accepted for a procedure. For example, the time it takes for a patient to have a heart catheterization procedure before being Indicator calculation: referred to a heart surgeon is not part of the waiting time shown for heart surgery (Access to Care Informatics, 2005). Waiting times for a catheterization done after a patient has been accepted for the surgery are included as acceptance does not equal medically ready. Numerator: N/A Denominator: N/A Inclusion and exclusion criteria: Inclusion Criteria: Only includes elective patients who are Ontario residents (Access to Care Informatics, 2008). Exclusion Criteria: None Data Source: Cardiac Care Network Provincial Patient Wait Times Registry in place since 1990. (Access to Care Informatics, 2011). MOHLTC\HSIMI\HA and HD Final

MLPA Final PI X s_(nov 14, 2011 Low Performance Indicator: Wait Times for Cataract Surgery Description: 90 th Percentile Wait Times for Cataract Surgery Indicator calculation: Step 1: Wait Days = Procedure Date Decision to Treat Date Patient Unavailable Days Step 2: Sort the records ascending. Patients with short wait days on top and patients with long wait days at the bottom. Step 3: Count the total number of cases and multiply by 0.90 (let s call this the 90thobs ). If this value has a decimal digit greater than zero then roundup. The 90th percentile wait time is the wait time of the 90thobs patient. The 90th percentile value is not interpolated. Numerator: N/A Denominator: N/A Inclusion and exclusion criteria: 1. Wait Time is calculated based on closed cases submitted by hospitals through the Wait Time Information System. 2. All closed wait list entries with procedure dates within date range 3. Must be 18 and older on the day the procedure was completed 4. Procedures no longer required are excluded from wait time calculation 5. Procedures assigned as priority level 1 are excluded from wait time calculation. 6. Wait list entries identified by hospitals as data entry errors are also excluded. 7. If unavailable days fall outside the decision to treat date up to procedure date, unavailable days are not deducted from patients wait days. These are considered data entry errors. Data Source: Cancer Care Ontario (Access to Care Informatics, 2011). MOHLTC\HSIMI\HA and HD Final

MLPA Final PI X s_(nov 14, 2011 Low Performance Indicator: Wait Times for Joint Replacement Description: 90 th Percentile Wait Times for Joint Replacement Indicator calculation: Step 1: Wait Days = Procedure Date Decision to Treat Date Patient Unavailable Days Step 2: Sort the records ascending. Patients with short wait days on top and patients with long wait days at the bottom. Step 3: Count the total number of cases and multiply by 0.90 (let s call this the 90thobs ). If this value has a decimal digit greater than zero then roundup. The 90th percentile wait time is the wait time of the 90thobs patient. The 90th percentile value is not interpolated. Numerator: N/A Denominator: N/A Inclusion and exclusion criteria: 1. Wait Time is calculated based on closed cases submitted by hospitals through the Wait Time Information System. 2. All closed wait list entries with procedure dates within date range 3. Must be 18 and older on the day the procedure was completed 4. Procedures no longer required are excluded from wait time calculation 5. Procedures assigned as priority level 1 are excluded from wait time calculation. 6. Wait list entries identified by hospitals as data entry errors are also excluded. 7. If unavailable days fall outside the decision to treat date up to procedure date, unavailable days are not deducted from patients wait days. These are considered data entry errors. Data Source: Cancer Care Ontario (Access to Care Informatics, 2011). MOHLTC\HSIMI\HA and HD Final

MLPA Final PI X s_(nov 14, 2011 Low Performance Indicator: Wait Times for MRI/CT Scans Description: 90 th Percentile Wait Times for MRI/CT Scans Indicator calculation: Step 1: Wait Days = Procedure Date Decision to Treat Date Patient Unavailable Days Step 2: Sort the records ascending. Patients with short wait days on top and patients with long wait days at the bottom. Step 3: Count the total number of cases and multiply by 0.90 (let s call this the 90 th obs ). If this value has a decimal digit greater than zero then roundup. The 90 th percentile wait time is the wait time of the 90 th obs patient. The 90 th percentile value is not interpolated. Numerator: N/A Denominator: N/A Inclusion and exclusion criteria: 1. Wait Time is calculated based on closed cases submitted by hospitals through the Wait Time Information System. 2. All closed wait list entries with procedure dates within date range 3. Must be 18 and older on the day the procedure was completed 4. Procedures no longer required are excluded from wait time calculation 5. Procedures assigned as priority level 1 are excluded from wait time calculation. 6. Wait list entries identified by hospitals as data entry errors are also excluded. 7. If unavailable days fall outside the decision to treat date up to procedure date, unavailable days are not deducted from patients wait days. These are considered data entry errors. 8. As of January 1, 2008, DI cases classified as specified date procedures (timed procedures) are excluded from wait time calculation. Data Source: Cancer Care Ontario (Access to Care Informatics, 2011). MOHLTC\HSIMI\HA and HD Final

MLPA Final PI X s_(nov 14, 2011 Percentage of Alternate Level of Care Days Low Description: Percentage of inpatient days where a physician (or designated other) has indicated that a patient occupying an acute care hospital bed has finished the acute care phase of his/her treatment. Data Source: CIHI Inpatient Discharge Abstract Database (DAD) Inclusion/Exclusion criteria: Inclusion: Data are retrieved from acute care hospitals. Exclusion: Newborns, stillborns, and records with missing or invalid Discharge Date are not included in this indicator. Methodology: Numerator = Total number of inpatient days designated as ALC in a given time period Denominator = Total number of inpatient days in a given time period Methodological Notes: All numbers used for calculations are as reported by the hospitals. The information is from each acute site of the hospital and the assignment to a is based on the postal code of the corporate head office site. Limitations: Data are collected continually so quarterly/annual tracking is possible. In-quarter data (as opposed to cumulative data) is presented. Q1 data is made available at the same time as Q2 data. Year end results may be issued in two waves: 1. preliminary results, 2. final results. The ALC days included are based on hospital discharge information and as such the measure does not include patients occupying ALC beds who have not been discharged. MOHLTC\HSIMI\HA and HD Final

MLPA Final PI X s_(nov 14, 2011 Low 90th Percentile ER Length of Stay Indicators EXCLUSION CRITERIA FOR NACRS FY 2011/12 [LEVEL 1] DATA Applicable to Ontario ER data from APRIL 2011 onwards Access to Care Informatics (ATCI), CCO will identify ER visits from NACRS (level 1) April 2011 data, for reporting purposes using the following criteria: Unscheduled ER visits captured under MIS functional centre codes 7*310* Cases are excluded from ED reports if they fall in ANY ONE of the following ER exclusion criteria: Cases where Patient Left ED Date/Time and Disposition Date/Time are both blank/unknown (9999) Cases where Registration Date/Time and Triage Date/Time are both blank/unknown (9999) Cases where patients over the age of 125 on the earlier of triage or registration date Duplicate cases within the same functional center where all ER data elements have the same values except for Abstract ID number Cases pertaining to Psychiatric assessment units reported in functional centre 7131070 - evaluated and approved by CCO's ED Information Program Cases where the Scheduled visit Indicator flag is = 'Y' If none of the Overall Exclusion Criteria applies to a record then Exclude_CD="0" Cases are excluded from specific performance metric calculations if they fall in ANY ONE of the following exclusion criteria: Key Performance Indicator Definition/Calculation Condition Exclusion Criteria - For ER Data Submission 1. Ambulance Offload time (AOT) Ambulance Transfer of Care date/time - For Ambulance Arrival ER Exclusion criteria Ambulance Arrival date/time Indicator A, G or C only Cases where Ambulance Arrival Date/Time is after the Ambulance Transfer of Care Date/Time 2. Time to Physician Initial Assess (PIA)* Physician Initial Assessment date/time - ED Triage/Registration Date/time (whichever is earlier / valid) 3. Time to Disposition Decision ED disposition date/time - ED Triage/Registration Date/time (whichever is earlier / valid) 4. Time to Admission (Admitted Patients Only; ED Disposition Codes 06 or 07) Date/time Patient Left ED - ED Disposition Date/time N/A Disposition code ED Disposition Code 06 or 07 Cases where Ambulance Arrival Date/Time and Ambulance Transfer of Care Date/Time is unknown (9999) or blank Cases where Ambulance arrival indicator is other than A, G or C AOT is greater than or equal to 100000 minutes (1666 hours) ER Exclusion criteria Cases where Physician Initial Assessment time is Unknown (9999) or blank Time to PIA is greater than or equal to 100000 minutes (1666 hours) ER Exclusion criteria Cases where Cases where Disposition Date/Time is unknown (9999) or blank Cases where patient has left without being seen by a physician during his/her visit (Disposition Code 02 & 03) Time to Disposition Decision is greater than or equal to 100000 minutes (1666 hours) ER Exclusion criteria Cases where Patient left ED date/time is 9999 (unknown) or blank Cases where ED Disposition codes are other than '06 and '07 Cases where Disposition date/time is 9999 (unknown) or blank Time to Admission is greater than or equal to 100000 minutes (1666 hours) MOHLTC\HSIMI\HA and HD Final

MLPA Final PI X s_(nov 14, 2011 Low 5. ED LOS - All Disposition ED Visits without designated CDU: Date/time Patient Left ED - ED Triage/Registration (whichever is earlier and valid) Date/time Note: If Patient Left ED Date/Time is unknown (9999) or blank, use Disposition 6. ED Admits at Midnight Number of patients with an ED Disposition code of 06 or 07 in the ED at midnight (daily average) 7. Total ED Visits Number of ED Visits 8. CDU Length of stay** CDU Date/Time Out or Patient Left ED Date/Time - CDU Date/Time In Note: If CDU Date/Time Out is unknown (9999) or blank, Patient Left ED Date/Time will be used, if available 9. ED LOS-Admitted Patients Date/time Patient Left ED - ED Triage/Registration Date/time ((whichever is earlier / valid) N/A ED disposition Code 06 or 07; ER Exclusion criteria Cases where Patient left ED date/time is unknown or blank and the Disposition Code is 06-09, 12, 14 (admitted and transferred patients) ED LOS is greater than or equal to 100000 minutes (1666 hours) Cases where patient has left without being seen by a physician during his/her visit (Disposition Code 02 & 03) Cases where Date/Time patient left ED is unknown (9999) or blank at midnight Cases where Disposition Date/Time is unknown (9999) Count based on Registration/Triage date ED Disposition Code 06 or 07 10. ED LOS-Discharged Patients Date/time Patient Left ED - ED ED Disposition Code 01 or Triage/Registration Date/time (whichever is 15 earlier / valid) If Date/Time patient left ED 11. ED LOS-Left without being seen Date/time Patient Left ED - ED ED Disposition Code 02 or 03 Triage/Registration Date/time ((whichever 12. ED LOS-Left without treatment Date/time Patient Left ED - ED Triage/Registration Date/time ((whichever is earlier / valid) ER Exclusion criteria Cases where Date/Time Patient left ED is unknown (9999) or blank and the Disposition Code is 06-09, 12, 14 (admitted patients and transferred patients) Cases where patient has left without being seen by a physician during his/her visit (Disposition Code 02 & 03) ER Exclusion criteria Cases from hospitals with non-designated CDUs Cases where CDU Date/Time In is before Triage / Registration Date/Time (whichever is earlier and valid) Cases where CDU admission Date/Time is after Date/Time Patient Left ED or CDU Date/Time out Cases where Patient Left ED AND CDU Date/Time Out is unknown (9999) or blank for CDU cases Cases where CDU Date/Time In is unknown (9999) or blank Cases where CDU Date/Time In is unknown (9999) or blank Cases where patient has left without being seen by a physician during his/her visit (Disposition Code 02 & 03) CDU LOS is greater than or equal to 100000 minutes (1666 hours) ER Exclusion criteria Cases where Date/Time Patient left ED is unknown (9999) or blank ED LOS (for Admitted Patients) is greater than or equal to 100000 minutes (1666 hours) ER Exclusion criteria ED LOS is greater than or equal to 100000 minutes (1666 hours) ER Exclusion criteria ED LOS is greater than or equal to 100000 minutes (1666 hours) ER Exclusion criteria ED Disposition Code 04 ED LOS is greater than or equal to 100000 minutes (1666 hours) * If PIA is less than or equal to 24 hours prior to registration/triage time i.e. when 'Time to PIA' is negative, the Time to PIA or PIA LOS will be set to 'zero'. ** CDU Length of Stay: ED facilities who have NOT informed CCO about their designated CDU status will be excluded, even if CDU Flag is 'Y' and/or other CDU fields are completed MOHLTC\HSIMI\HA and HD Final

MLPA Final PI X s_(nov 14, 2011 Low Repeat Unscheduled Emergency Visit Within 30 days for Mental Health & Substance Abuse Conditions Note: The methodology for this indicator has been revised for 2011/12. The revisions include: 1. Beginning April 2011 the visit type data element was retired from NACRS data collection. This data element was used in prior reporting periods to identify "unplanned" visits. Consistent with this change in NACRS data collection this performance indicator now includes all emergency visits (both planned and unplanned). 2. To more precisely measure the time interval between two ER visits the method has been revised to measure the time interval between the disposition date of the index visit and the registration date of the next visit. Previously the method measure the time interval between the registration dates of the index and the repeat visit. A repeat ER visit has occurred if the interval is less than or equal to 30 days. For the detailed methodology change and its impact to the indicator, please refer to the "MOHLTC Performance Agreement Local Health System Performance Indicators Technical Information" (August 12, 2011) or contact Domenic Della Ventura (Domenic.Dellaventura@ontario.ca). Data Source: Ontario Ministry of Health and Long-Term Care, NACRS, IntelliHealth, 2010/11 Inclusion/Exclusion criteria: Includes information on unscheduled emergency department visits to Ontario hospitals for Mental Health and Substance Abuse conditions, defined by the main problem diagnosis in ICD-10-CA Chapter 5. The diagnostic categories refer to the main problem diagnosis (the problem deemed to be the most clinically significant reason for the visit) and are based on ICD-10-CA diagnoses. Mental Health: All ICD-10-CA codes beginning with 'F', excluding Substance Abuse. Substance Abuse: ICD-10-CA codes beginning with 'F10' - 'F19'. The analysis excludes visits for those without a valid health card number. The patient assignment is consistent with the IntelliHealth assignment. Methodology: For each quarter the data period is extended to include 30 days after the last day of the reporting quarter to avoid undercounting of qualified repeat visit pairs that have the 'index' visit in the reporting quarter and a 'repeat' visit in the next quarter. Note that this 30 day period is based on 2010/11 Q1 interim data which may be subject to change. A visit is counted as an 'index' visit if it is followed by another visit that occurs in any Ontario hospital within 30 days, for any diagnosis within the ICD-10-CA Chapter 5. The 'repeat' visit can be for either a mental health or substance abuse condition. The diagnostic category and groups refer to the diagnosis reported for the 'index' visit. Numerator = Total # of emergency visits in the reporting quarter that followed by another visit within 30 days for mental health (or substance abuse) conditions, by of patient residence. Denominator = Total # of emergency visits in the reporting quarter for mental health (or substance abuse) conditions, by of patient residence. Limitations: The 2010/11 Q1 and Q3 calculations are based on interim data, which are subject to change. The method for this indicator has been revised, therefore the magnitude of values for 2010/11 Q3 may differ from those for previous MLPA reporting periods. It is recommended that comparisons of performance across quarters should be based on the results using the same methodology. MOHLTC\HSIMI\HA and HD Final

MLPA Final PI X s_(nov 14, 2011 Low 90th Percentile Wait Time In Days for CCAC In-Home Services Application from Community Setting to first CCAC service (excluding case management) Data Source: Inclusion Criteria Stratifications: Home Care Database (HCD), SAS EG Server, Ontario Ministry of Health and Long-Term Care - FY2011/12 Q1 Service Date = April 1, 2011 to June 30, 2011 Home Care Program Types = In-Home (01); Adult Day Care (05); Supportive Housing (06) Assessment Outcome = Eligible Clients Only 12; 15; 16 Service Type is NOT EQUAL to Case Management (10) Wait Time is between 0 and 365 Days Fiscal Year: based on the first Service Date Fiscal Quarter: is based on the first Service Date : CCAC recorded on the Application Form Referral Source: Defined by variable Referral Source. Hospital referrals are first identified as Referral Source equal to 1 (general hospital-outpatient), 2 (general hospital-inpatient), 3(special hospital-outpatient), or 4 (special hospital-inpatient). All non-hosptial referrals are identified as community referrals. The methodology to identify community referrals has been revised for 2011/12. The revision includes: Notes: To be more precisely define community referrals and consistent with MSAA, the methodology has been revised to use Referral Source to define referring settings. First the hospital referrals are identified using the Referral Source 1 (general hospital-outpatient), 2 (general hospital-inpatient), 3 (special hospital-outpatient), and 4 (speical hospital-inpatient). Then all the remaining non-hospital referrals are identified as community referrals. Previously the variable Prior Site Code were used to identify the referring settings. For detailed methodology change and its impact to the indicator, please refer to the"mohltc Performance Agreement Local Health System Performance Indicators Technical Information" (August 12, 2011) or contact Domenic Della Ventura (Domenic.Dellaventura@ontario.ca). MOHLTC\HSIMI\HA and HD Final

MLPA Final PI X s_(nov 14, 2011 Low Readmissions within 30 days for Selected CMGs Description: The number of patients readmitted to any facility for non-elective inpatient care. This is compared to the number of expected non-elective readmissions using data from all Ontario acute hospitals. Data Source: Discharge Abstract Database (DAD), CIHI. Inclusion/Exclusion criteria: Acute inpatients in the specified CMGs (see the table below), age restrictions are cohort specific: 45 for stroke, COPD, CHF, 40 for cardiac CMGs, all ages for pneumonia, diabetes and GI. The readmission hospitalization is deemed nonelective or unplanned if: a) the admission date is within 30 days of the index case discharge date; b) the DAD field admission category is urgent. Exclude deaths, transfers, patient sign-outs against medical advice; records with missing valid data on discharge/admission date, health number, age and sex. Methodology: Readmission to any facility for selected CMGs = Observed number of patients, discharged with specified CMGs within calendar year, readmitted to any facility for any nonelective patient care within 30 days of discharge for index admission Indicator Calculation: Step 1: Identify index cases (Denominator): Select all discharges among the selected CMGs with discharge dates for period in question and age restrictions as described in Inclusions section. Include only typical and outlier cases (based on DAD RIW Exclusion Indicator) among the index cases. Step 2: Calculate observed readmission (Numerator): The sum of readmissions for all index cases in a calendar years: For each index case, identify whether there is a non-elective readmission to any facility within 30 days of discharge. The readmission hospitalization is a non-elective readmission event if: - The admission date is within 30 days of the index case discharge date; - The DAD field admission category is urgent; and - Patient admission is not coded as an acute transfer by receiving hospital, keep as readmission if admitted to own hospital. Potential for Historical Trends: Data are collected quarterly so quarterly/annual tracking is possible. Limitations: Note that the interim data may be subject to change. MOHLTC\HSIMI\HA and HD Final

MLPA Final PI X s_(nov 14, 2011 Low CMG+ 25 26 28 139 136 138 143 196 437 202 204 208 231 248 251 253 254 255 256 257 258 285 286 287 288 List of Eligible Conditions (CMGs) CMG+ description Stroke (Age 45) Hemorrhagic Event of Central Nervous System Ischemic Event of Central Nervous System Unspecified Stroke COPD (Age 45) Chronic Obstructive Pulmonary Disease Pneumonia (All ages) Bacterial Pneumonia Viral/Unspecified Pneumonia Disease of Pleura Congestive Heart Failure (Age 45) Heart Failure without Cardiac Catheter Diabetes (All ages) Diabetes Cardiac CMGs (Age 40) Arrhythmia without Cardiac Catheter Unstable Angina/Atherosclerotic Heart Disease without Cardiac Cath Angina (except Unstable)/Chest Pain without Cardiac Catheter Gastrointestinal CMGs (All ages) Minor Upper Gastrointestinal Intervention Severe Enteritis Complicated Ulcer Inflammatory Bowel Disease Gastrointestinal Hemorrhage Gastrointestinal Obstruction Esophagitis/Gastritis/Miscellaneous Digestive Disease Symptom/Sign of Digestive System Other Gastrointestinal Disorder Cirrhosis/Alcoholic Hepatitis Liver Disease except Cirrhosis/Malignancy Disorder of Pancreas except Malignancy Disorder of Biliary Tract MOHLTC\HSIMI\HA and HD Final