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Provincial Governments/Regional Authorities/Hospitals

Provincial Governments and Public Health

Hospitals Internal Accountability

Cancercare Ontario and Hospitals

Regional Health Authorities and Community

Provincial Government and Nursing Homes

Local Governments and Homes for the Aged

Provincial Governments and Lab Services

Provincial Governments/Regional Authorities and Primary Care

Professional Regulatory Bodies

Regional Health Authorities and Communities

Research Team:
Janet Lum
Paul Williams
Raisa Deber
Whitney Berta
Carolyn Steele-Gray (student)

Accountability in health care has become a topic of great interest to academics, public servants, and the broader public, particularly in light of recent health care reform efforts and increased calls for greater accountability in the public sector. However, there is evidence to suggest that some accountability tools, such as performance measurement, will result in unintended and perverse organizational outcomes. Some studies have shown that accountability may lead to less desirable individual level behaviours rather than promoting more positive organizational environments. Given the increased interest in accountability and its potential for improving health care system sustainability and quality, it is important to know whether organizations are responding to accountability demands as expected and desired, or whether accountability is leading to perverse behaviours and unintended organizational responses which may negatively impact on how health services are delivered. 

This research will examine accountability frameworks in the home and community care sector in Ontario, specifically focusing on how community support services (CSS) organizations respond to accountability tools imposed on them. This will be a two-phased, sequential mixed-methods study which will incorporate document analysis, an environmental scan, a survey, and semi-structure interviews.

Anne Wojtak - Toronto Central CCAC
Nadine Henningsen - Canadian Home Care Association
Judith Shamian - Victorian Order of Nurses
Deborah Simon - Ontario Community Support Association


Oral Presentation: “Organizational Responsiveness to Accountability.”
Presented May 5th at HPME Research Day 2010, held in Toronto, ON May 5th 2010.

Panel Presentation: “Approaches to Accountability in Health Care.”
Presented May 12th at the CAHSPR (Canadian Association for Health Services and Policy Research) Conference 2010, held in Toronto, ON, May 10th-13th 2010.

Poster Presentation: “Organizational Responsiveness to Accountability.” Presented at the Academy Health Conference 2010, held in Boston, MA. June 27th-29th 2010.

Oral Presentation: “Accountability in the Home and Community Care Sector in Ontario”
Presented October 18th at the OCSA (Ontario Community Support Association) Great Ideas Conference 2011, held in Markham, Ontario.

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