The Emerging Role of the Board in Quality and Patient Safety

Ontario hospitals have a long and proud history of local and independent voluntary governance, the only province in Canada with such a governance model.

Our volunteer trustees help hospitals ensure they are in-tune with the expectations of their communities and better positioned to respond to their own local, and even national or global challenges and needs. Ontario hospitals are led by trustees with varied experiences, skills and perspectives rooted in their communities.  Trustees provide an additional lens for viewing hospital activities – a lens that filters a variety of external influences, such as the economy, technology, accountability, and quality – but from an “informed outsiders” perspective.

These highly skilled boards have helped Ontario’s hospitals meet new challenges successfully. As the work of Ontario’s volunteer hospital boards becomes more complex, more demanding and more scrutinized, trustees are stepping up and embracing their expanding and evolving roles. This includes the multitude of new legislative and regulatory changes, such as the Government of Ontario’s Excellent Care for All Strategy,  designed to enhance boards’ responsibilities related to quality, patient safety, transparency, and overall accountability . Boards know that new initiatives and requirements test their ability to meet public expectations respecting their care.

Advancing Quality and Patient Safety Governance in Ontario

Ensuring that Ontario’s health care system is accountable to the public for providing quality care is a key objective of the Excellent Care for All Act, 2010. Much of the responsibility for fulfilling these legislative requirements rests with governing hospital boards. This toolkit provides practical information in the form of templates that boards can use and adapt to their organizations as they carry out their governance responsibilities.

There are many components to quality and patient safety governance, beginning with the quality of the board and its practices, which helps ensure that board members are effective stewards of quality at their organizations. Effectively overseeing the quality agenda at the board level requires linking the organization’s strategy to measurement and reporting in order to track performance on quality and patient safety initiatives.

Boards also achieve their quality improvement goals through strong relationships. Board-management working relationships that support quality rely on trust and accountability. Ensuring effective relationships with physicians and clinical leaders can also help boards understand the various perspectives that contribute to quality care. Ultimately, an organization’s quality agenda is about how the care provided affects patients and their families. Boards can support practices focused on empowering patients and families, including having patients inform and support initiatives for quality, patient safety and accountability.

Each organization follows a different path to improving patient safety and quality governance.  The intent of this toolkit is to provide customizable guidance for the unique needs of each organization.