Accreditation Canada's Leadership standards help Canadian health care leaders pursue excellence in leadership within organizations that have a true commitment to client- and family-centred care. They are based on research and best practice and align with the Framework for the Analysis of Management in Health Care Organizations and Proposed Standards for Practice, researched and developed by J.L. Denis et al. (2006). The standards address leadership functions across and throughout all levels of the organization, rather than individual or position-specific capabilities. They clarify the requirements for effective operational and performance management supports, decision-making structures, and infrastructure needed to drive excellence and quality improvement with the primary focus being on creating a culture focused on client- and family- centered care.
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 Leadership standards are grouped into four sections that each address a key leadership responsibility that organizations must have in place as part of their pursuit of quality and safety:
Creating and sustaining a caring culture: Addresses identifying, strengthening, and disseminating the culture and values throughout the organization. In particular, it addresses the need for health care organizations to create a culture that supports a safe and healthy work environment and ongoing quality improvement.
Planning and designing services: Addresses the organization's ability to assess trends in the environment, including the service needs of the populations it serves, and use that information to plan its structures, management systems, and services. It also deals with the organization's relationships with stakeholders and its processes to manage change.
Allocating resources and building infrastructure: Addresses managing resources, working with partners to share and optimize resources, allocating resources fairly and in accordance with organizational priorities, human resources and performance management systems, the physical environment, and information systems infrastructure.
Monitoring and improving quality and safety: Addresses the organizational systems and processes needed to deliver safe, high quality services and achieve the organization's goals and objectives, including assessing and improving client flow, preparing for disasters and emergencies, and improving patient safety on an ongoing basis.
The approach taken to meet these responsibilities will vary according to the organization's size, structure, and mandate. Some criteria specify that certain responsibilities and activities are carried out in collaboration with the governing body. In organizations where there is no governing body, the organization's leaders take responsibility for these. In some jurisdictions, government may be involved in the operations of the organization and will be responsible for certain activities outlined in these standards. When this is the case, the organization's leaders remain as involved as possible in the process.
As you consider Accreditation Canada's Leadership standards and criteria, you may want to refer to the Leadership Capabilities Framework, LEADS in a Caring Environment. A framework developed to strengthen health care leadership capacity, Leads in a Caring Environment is based on current literature, best practice, and a systematic review of existing leadership competency frameworks. The framework represents the key skills, abilities, behaviours and knowledge required for health leaders at all levels and includes five domains: Lead Self, Engage Others, Achieve Results, Develop Coalitions, and Systems Transformation. Each of these five domains consists of four core measurable leadership capabilities.
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.