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Success in a New Era of Accountability for Health Care Organizations


​Health care organizations across the nation are under growing pressure to demonstrate Canadians are getting value for their health care dollars. In this new era of accountability, not only do health care organizations have to be more open about their spending and their results, they must justify and account for that spending and show how it effectively contributes to positive health outcomes.

Accelerating the Accountability Journey: Where to Start
Implementing or improving accountability is a significant undertaking for any health care organization, but it is an achievable one. In our experience working with clients across Canada’s health care system, we’ve found a number of ways organizations can streamline and even accelerate their accountability journey.

  • Accept that accountability is here to stay - Governments will change, and accountability priorities may well shift with them. But given Canada’s current economic outlook, health care organizations should get used to funding constraints, cost pressures and a public determined to know what value they receive for their health care dollars
  • Don’t be overwhelmed, tackle the challenge head-on - Suddenly being held accountable for health care decisions can be incredibly daunting for an organization. It’s important not to let the pressure lead to paralysis or a flurry of poorly conceived actions that’s don’t result in any progress. Stepping back to understand what accountability means to the organization, and carefully assessing how to meet those obligations, is key. Don’t panic
  • Start small - It’s all too easy to get bogged down in the sheer complexity of bringing more accountability to a health care organization. Instead, organizations should keep it simple, and start small — report on a limited set of metrics in one area, for instance. This will provide an early win, some important experience, and the foundation for future work
  • Focus on outcomes, not processes - Organizations should ensure that the indicators they use provide data about results, not interim steps in the process. Stakeholders, including the public, are interested in outcomes and end products — not the journey
  • Capitalize on what’s already available - Organizations often scramble to identify new data and indicators as they ramp up their accountability efforts. They should start by looking at the indicators and metrics they’re already collecting and reporting: they may discover those indicators can be used in new and unexpected ways to provide insight into other areas
  • Stay lean, be efficient - As organizations inventory the data available to them for their accountability program, they may discover they’ve been collecting data that serves little or no purpose. If a long-standing indicator isn’t relevant to today’s accountability program goals, it’s time to stop gathering it. It’s a wasted effort
  • Understand the accountability agreement - It seems obvious, but in our experience some health care organizations’ board members don’t take the time to read and understand the accountability agreement they operate under. Others focus on the portion of the agreement that’s related to funding and overlook the rest. Not understanding these vital agreements can lead to embarrassing situations — or worse.
  • Communicate, communicate, communicate - Clear communications are absolutely vital to the success of any accountability program. Health care organizations need to have open and honest conversations with the other parties to their accountability agreements, in order to foster a mutual understanding of the rationale, purpose and context for the agreement’s targets and measures. And if an organization finds itself at risk of breaching its agreement, it’s essential to be upfront and forthright about it, providing advance warning and avoiding unpleasant surprises down the road

The Accountability Era Is Here. Is Your Organization​ Ready?
The demands for more accountability across Canada’s health care system are only likely to grow in years to come, as financial pressures run up against the public’s demand for better care and more value for money. Health care organizations in all provinces and territories will need to become more comfortable with being held accountable for performance — and more adept at measuring it, as well.

Those who take steps now to better understand their accountability agreement and identify the right measures and optimal indicators will find themselves better equipped to delivering the meaningful insights stakeholders demand. ​

For more information, contact Greg Lamothe, MBA, BMR (OT), CMC, at 1.877.500.0795 or [email protected]

Read MNP’s whitepaper The New Era of Health Care Accountability, here.​