Health Council Canada

The Health Council of Canada has developed a set of criteria and an evaluation framework to support its efforts to report on health and health care practices that have demonstrated positive impacts on health care delivery, health promotion and health. The approach used is meant to standardize the categorization of these practices within the Health Council's definitions, and not meant to be a definitive classification of these practices. In the description of the Innovative Practices Evaluation Framework outlined below, specific caveats are noted that make this approach specific to the Health Councils purpose and goal for reporting on innovative practices.

Goals	Purpose	Innovative Practices
To support the identification, sharing and uptake of innovative health care practices, policies, programs and services that have been demonstrated (through our evaluation framework) to strengthen Canada's health care system.	To inform Canadians and to share innovative health care practices, policies, programs and services so that similar practices can be adopted elsewhere in Canada.	The Health Council has chosen to use the term 'Innovative Practices' to refer to the practices it profiles. Within 'Innovative Practices,' there are three levels: Emerging, Promising and Leading Practices (Figure 1; definitions described below)

This stepwise categorization of innovative practices captures the different stages practices may be in at the time of reporting. However, the basis for classifying the type of practice will not solely be based on the rigour of evidence, but rather different stages of the three criteria: outcomes/impact of the practice, recognizability of the practice and applicability/transferability of the practice. These criteria are described in further detail in the Evaluating Practices section.

Emerging Practices
Practices that are in preliminary stages of development; may have little to no outcomes data collected, may not be widely recognized.

Promising Practices
Practices that are at intermediate stages of implementation; have some outcomes data showing positive impact, may have some recognition outside of original setting and outreach for implementation elsewhere.

Leading Practices
Practices with widely accepted evidence of having a positive impact, wide recognition and/or breadth of implementation.

Evaluating Practices - The Innovative Practices Evaluation Framework

Criteria

To be eligible for evaluation using the Innovative Practices Evaluation Framework, the practices must meet the following Inclusion Criteria:

Practices must be those that address a need or gap related to a health accord theme, or is of interest to Canadians;
There must be, at minimum, an intention or plan to evaluate the impact of the practice or, in the absence of an evaluation plan, have collected anecdotal evidence of the positive impact of the practice (that is, demonstrate positive outcomes);
Practices do NOT include specific drug, surgical or medical interventions; these practices warrant evaluation through a more appropriate process, such as a systematic review and/or meta-analysis. In some rare instances the Health Council may wish to profile a practice that falls within in this category. In these cases, there MUST be existing evidence from an externally published systematic review and meta-analysis to support the outcomes/impact criteria.

If a practice meets all of the above criteria, they can be evaluated using the Innovative Practices Evaluation Framework based on the following Evaluation Criteria

Outcomes/Impact of practice (evidence showing that a practice has had a positive impact)
Recognizability of the practice (the extent to which a practice is recognized specifically by those for whom the practice is intended as well as other relevant decision-makers and stakeholders)
Applicability/Transferability of the practice (the extent to which a practice can be or has been adapted for use outside of its original setting)

Innovative Practices Evaluation Framework

Evaluation Criteria

Emerging Practice

Promising Practice

Leading Practice

Outcomes/ Impact

There is an intention or plan to evaluate impact of practice or there is at least some anecdotal evidence of a positive impact

Pilot data (e.g., small sample size, preliminary data, or data collected whilst practice evaluation is on-going) or formative data (e.g., preliminary evidence) demonstrating positive impact

Robust data (e.g., widely accepted and recognized; could be published in an academic journal) or summative data (e.g., findings at end of program) demonstrating a positive impact

Recognizability

Practice is recognized ONLY by those directly involved (e.g., providers, patients, administrators of the facility, funders, etc)

In addition, practice is also recognized by those outside of the original setting to whom the practice is relevant (e.g., patients, providers) and to a few other relevant decision-makers and other stakeholders

Recognized by a wide range of patients, providers, decision makers, other stakeholders. May be a topic of media coverage

Applicability/ Transferability

The practice is ONLY used in one setting at this point (e.g., one location, one clinic and one patient group); may have the potential for use in other settings

The practice has the potential to be used/ adapted/transferred in/to other settings, and/or geographic locations, and/or patient groups, and is currently being implemented in at least one other setting, location or patient group outside of the original setting

The practice is being used in a broad range of settings and/or locations and/or patient groups beyond the original setting (i.e., in multiple locations and in different settings and/or patient groups)