Mackenzie Health
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Professional Practice - Nurse Sensitive Adverse Events (NSAEs)


The Canadian Hospital Reporting Project (CHRP) is a quality improvement initiative developed by the Canadian Institute of Health Information (CIHI). The objectives are to provide comparable indicators to support performance measurement and quality improvement among Canadian hospitals. Over 600 facilities report on 21 clinical and six financial indicators. The indicators, selected by experts in the field, measure: clinical effectiveness, patient safety, appropriateness of care, accessibility, and financial performance. Nurse Sensitive Adverse Events (NSAE) is one of the 21 clinical indicators CIHI collects data on. The four nursing sensitive clinical domains are: hospital acquired pneumonia (HAP), urinary tract infections (UTI), pressure ulcers (PU), and in-hospital fractures. Following publication of the 2011-12 NSAE, the leadership at Mackenzie Health (MH) is committed to the development of strategies to improve quality and safe patient care.  The result of these organizational quality improvement initiatives is a sustained dramatic decrease in NSAE at MH over the last two years. 52% and 40% improvement in Surgery and Medicine, respectively (see charts below).





The cost of NSAEs can be calculated by using the publicly accessible CIHI Patient Cost Estimator, which is based on the Case Mix Groups. The percent improvement that we have achieved in NSAEs can be translated into an estimate of cost avoidance. The most conservative estimate is $480,000 annually from the medicine and surgery units due to the reduction of NSAEs (i.e. a comparison between FY2011/12 & FY2012/13).


There is no cost metric that can be attached to human life and suffering. An adverse event affects everyone in the patients’ circle of care and can have a negative impact on their socio-economic condition and family structure. Preventing NSAE will continue to improve our patients and their family’s health care experience, support sustainability, and raise the hospital’s reputation as on as one of the best health systems in Ontario.


The NSAEs data is publicly accessible. Visit for more information.

Mackenzie Health / 10 Trench St. Richmond Hill, On. L4C 4Z3 / Richmond Hill Line: 905-883-1212 or Vaughan Line: 905-832-4554 / TTY Service: 905-883-2123
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