Accreditation Canada's Governance Standards help health organizations meet demands for excellence in governance practice. They are a response to system-wide changes in health care delivery structures and an increasing need for public accountability.
The Governance Standards are meant to be used by the governing body in conjunction with Accreditation Canada's Leadership Standards, used by the organization's leaders. The responsibility of the governing body to be engaged and involved in the activities of the organization, in particular those pertaining to quality, safety, and a culture of client- and family-centred care, is critical for the organization's success.
Accreditation is one of the most effective ways for organizations to regularly and consistently examine and improve the quality of their services. The standards provide a tool for organizations to embed accreditation and quality improvement activities into their daily operations with the primary focus being on including the client and family as true partners in service delivery.
Client- and family-centred care is an approach that guides all aspects of planning, delivering and evaluating services. The focus is always on creating and nurturing mutually beneficial partnerships among the organization’s staff and the clients and families they serve. Providing client- and family-centred care means working collaboratively with clients and their families to provide care that is respectful, compassionate, culturally safe, and competent, while being responsive to their needs, values, cultural backgrounds and beliefs, and preferences (adapted from the Institute for Patient- and Family-Centered Care (IPFCC) 2008 and Saskatchewan Ministry of Health 2011).
Accreditation Canada has adopted the four values that are fundamental to this approach, as outlined by the IPFCC, and integrated into the standards. The values are:
- Dignity and respect: Listening to and honouring client and family perspectives and choices. Client and family knowledge, values, beliefs, and cultural backgrounds are incorporated into the planning and delivery of care.
- Information sharing: Communicating and sharing complete and unbiased information with clients and families in ways that are affirming and useful. Clients and families receive timely, complete, and accurate information in order to effectively participate in care and decision-making.
- Partnership and participation: Encouraging and supporting clients and families to participate in care and decision making to the extent that they wish.
- Collaboration: Collaborating with clients and families in policy and program development, implementation and evaluation, facility design, professional education, and delivery of care.
The Governance Standards are built on five key functions of governance, aligning with J.L. Denis et al.'s Towards a Framework for the Analysis of Governance in Healthcare Organizations. These five key functions are: developing the mission, vision, and values; collecting and using knowledge and information; developing the organization; building relationships with stakeholders; and demonstrating accountability.
The standards are grouped into four sections based on these functions:
Functioning as an effective governing body: Addresses the internal development of the governing body, including composition, structure, and roles and responsibilities including the division of responsibility with organization leaders.
Developing a clear direction for the organization: Addresses the process for defining the organization's mission and long-term vision, including broad organizational goals and values.
Supporting the organization to achieve its mandate: Addresses the governing body's role in the processes that support the organization's achievement of its strategic goals and objectives. It includes
the recruitment and evaluation of the Chief Executive Officer (CEO), relationships with the CEO and the organization's other leaders, and resource allocation.
Being accountable and achieving sustainable results: Addresses accountability and organizational performance, including quality improvement and risk management.
The approach a governing body takes to address these responsibilities will differ according to the organization's size, structure, mandate, and governance model. In some cases the organization's CEO and other leaders will be directly involved in many of the governance activities and responsibilities outlined here, while in other cases there will be a more distinct division of responsibilities.
In some jurisdictions, government may be involved in the operations of the organization's governing body, and will be responsible for certain activities outlined in these standards. When this is the case, the governing body should remain as involved as possible in the process.
All Accreditation Canada standards are developed through a rigorous process that includes a comprehensive literature review, consultation with a standards working group or advisory committee comprised of experts in the field, and evaluation by client organizations and other stakeholders.