In 1999, the Nursing Task Force Report, Good Nursing, Good Health : An Investment for the 21^st Century, was released to respond to health care reform initiatives that would lead to changes in the overall health system. It recommended a variety of changes to nursing practice to ensure continued public access to high quality nursing services.

One of the recommendations focussed on the need for a funding method for nursing that would be responsive to the needs of the health care consumer. It recommended that the funding formula should be based on performance standards promoting high quality patient outcomes, and on health information systems that would provide comprehensive and reliable data on nursing services.

A series of consultations with experts in outcomes and funding methodologies were held leading to the development of a framework for the Nursing and Health Outcomes Project. The framework identified the need to analyze current data bases to determine nursing relevant content and nurse-sensitive patient outcomes along with their associated structures and processes.

The goal was to identify nursing-sensitive patient outcomes and their attendant nursing inputs and processes that could be abstracted from patients' charts or provided in other formats. This information would allow nurses to plan their care with the objective of achieving the best patient outcomes, and would allow administrators and researchers to describe how different nursing interventions and different numbers and types of nurses (RNs, RPNs) affect patient outcomes.

While the original focus was on nursing, the scope of the project has been expanded under the IM Strategy to include other interdisciplinary team members starting with pharmacists, occupational therapists and physical therapists.

The government is committed to improving information and information management of the health system because results will help contribute to quality improvement, cost effectiveness and improved accountability. HOBIC will begin to fill the gap in information about what health care professionals contribute to patient care.

The initiative includes a number of phases. Phase one (Background Work) and Phase two (Pilot projects) used the name, Nursing and Health Outcomes Project (NHOP); Phase three is known as Health Outcomes for Better Information and Care (HOBIC) and will reflect implementation.

We need this information :

• To evaluate clinical practice
• To help managers and decision-makers make improvements to the efficiency and effectiveness of the health system
• To compare results across practice settings for benchmarking best practices

We will use this information :

• To compare information related to health outcomes cross health settings
• To inform transformation of our health system
• To facilitate planning, co-ordinating and managing care across Ontario's health services
• To provide information for future health human resource decisions