ABSTRACT
This study aimed to enhance understanding of the dimensions of accountability captured and not captured in acute care hospitals in Ontario, Canada. Based on an Ontario-wide survey and follow-up interviews with three acute care hospitals in the Greater Toronto Area, we found that the two dominant dimensions of hospital accountability being reported are financial and quality performance. These two dimensions drove both internal and external reporting. Hospitals' internal reports typically included performance measures that were required or mandated in external reports. Although respondents saw reporting as a valuable mechanism for hospitals and the health system to monitor and track progress against desired outcomes, multiple challenges with current reporting requirements were communicated, including the following: 58% of survey respondents indicated that performance-reporting resources were insufficient; manual data capture and performance reporting were prevalent, with the majority of hospitals lacking sophisticated tools or technology to effectively capture, analyze and report performance data; hospitals tended to focus on those processes and outcomes with high measurability; and 53% of respondents indicated that valuable cross-system accountability, performance measures or both were not captured by current reporting requirements.
Subject(s)
Critical Care , Financial Management, Hospital/legislation & jurisprudence , Hospital Administration/legislation & jurisprudence , Outcome and Process Assessment, Health Care/standards , Quality Indicators, Health Care/legislation & jurisprudence , Social Responsibility , Accreditation/standards , Financial Management, Hospital/methods , Government Regulation , Health Planning , Health Priorities , Hospital Administration/economics , Humans , Mandatory Reporting , Ontario , Organizational Case Studies , Outcome and Process Assessment, Health Care/methods , Quality Indicators, Health Care/economics , Reimbursement, Incentive/standardsABSTRACT
Community Health Centres (CHCs) are grounded in a model of care that includes engagement with the community and have a history of working with communities to respond to emerging needs. Although most CHCs consider themselves to be integrated, mergers in this sector are uncommon. In Ontario, the first voluntary merger of CHCs showed the importance of community engagement to realize the intended benefits of the integration and to effectively manage change.
