title: Hospitals' internal accountability.
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.
authors.affiliation: Senior Manager, Patient Experience, Cancer Care Ontario, Toronto, ON.
authors.forename: Nancy
authors.initials: N
authors.lastname: Kraetschmer
authors.affiliation: Vice-President, Operations and Transformation, Bridgepoint Health, Toronto, ON.
authors.forename: Janak
authors.initials: J
authors.lastname: Jass
authors.affiliation: Director, Strategy and Performance, Women's College Hospital, Toronto, ON.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Woodman
authors.affiliation: Quality Lead, Ambulatory Programs, The Hospital for Sick Children, Toronto, ON.
authors.forename: Irene
authors.initials: I
authors.lastname: Koo
authors.affiliation: Postdoctoral Fellow, Health System Performance Research Network, University of Toronto, Toronto, ON.
authors.forename: Seija K
authors.initials: SK
authors.lastname: Kromm
authors.affiliation: Professor, Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON.
authors.forename: Raisa B
authors.initials: RB
authors.lastname: Deber
mesh_terms: D000068:Accreditation / Q000592:standards; D003422:Critical Care; D005377:Financial Management, Hospital / Q000331:legislation & jurisprudence* / Q000379:methods; D033161:Government Regulation; D006285:Health Planning; D006292:Health Priorities; D006739:Hospital Administration / Q000191:economics / Q000331:legislation & jurisprudence*; D006801:Humans; D019221:Mandatory Reporting; D009864:Ontario; D019982:Organizational Case Studies; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000191:economics / Q000331:legislation & jurisprudence*; D012052:Reimbursement, Incentive / Q000592:standards; D012941:Social Responsibility