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Data-driven Government

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Much as been written about bringing effective analytics to government (and by extension, quasi-governmental organizations such as regulators), and we have seen leaders emerge in this area. Overall, though, the process of translating the available research, knowledge and practices into action has been slow. There are strategies for addressing the challenges faced by public sector organizations in adopting and embracing a data-driven culture, many coming from private sector organizations such as Hewlett Packard and IBM.

Click to access Strategic%20Analytics.pdf

 

Click to access empowering_a_data-driven_government.pdf

Systems Engineering and Health Care: A Match Made in Heaven

Dr. Peter Pronovost was a pioneer in hospital checklists, a simple, low-cost harm reduction tool already in widespread use in aviation for more than a half century. Now he’s bringing more systems thinking into the healthcare fold, this time applying systems engineering to streamline and make key health information readily accessible to practitioners, patients and families.

https://hbr.org/2017/02/how-systems-engineering-can-help-fix-health-care

 

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The Wonders of Checklists

A simple checklist prevents deaths after surgery, a large new study suggests

Washington Post, April 18, 2017

The Washington Post reports that a recent South Carolina study examining 30-day post-surgical mortality rate of hospitals found a reduction in deaths for those hospitals participating in a voluntary checklist-based quality improvement program, over those hospitals that were not. The study is to be published in August 2017.

I find checklists fascinating – especially when used as tools in technically demanding fields such as aviation and medicine. They are an incredibly cheap, easy-to-use and low-tech solution in fields of ever-expanding technical complexity. Yet they do have limitations, and they have taken an inordinate amount of time to be fully-embraced by hospital personnel.

For followers and practitioners of patient safety and health quality, the study’s conclusion comes as no surprise, but it does raise questions. In today’s post, I’d like to examine the history and benefits of checklist adoption. Subsequent posts will consider the limitations of checklists, the dissemination of ideas, and the implications of checklists for regulatory effectiveness – the theme of this blog.

Continue reading “The Wonders of Checklists”

Update on Bill 87 (Ontario) – The Protecting Patients Act, 2016

Bill 87 – The Protecting Patients Act, 2016

Bill 87 was introduced by the province in December 2016 to amend several different health statutes, including the Regulated Health Professions Act, 1991 (RHPA).

This is a summary and discussion of select proposed amendments to the RHPA, which will affect the 26 health profession regulators (Colleges) established under that statute.[1] I have made comments throughout, and at the end of this post. 

Second Reading Completed

As of April 4, 2017, Bill 87 has undergone second reading, meaning that it has been debated by the legislature in principle, and has now been referred to standing committee, during which time public hearings may be held and amendments considered. The debate during second reading was reportedly closed early.

Amendments to Regulated Health Professions Act

The proposed amendments to the RHPA followed the release of the 2016 report[2] of the Minister’s sexual abuse task force, which set out many recommendations, not all of which were incorporated into the current bill.

Broadly speaking, the proposed amendments to the RHPA can be categorized as follows:

  • Sexual abuse amendments
  • Increased Ministerial powers
  • Power to make interim suspensions
  • Changes to complaints process
  • Enhanced transparency of College information
  • Increased reporting obligations of members

Continue reading “Update on Bill 87 (Ontario) – The Protecting Patients Act, 2016”

Tarion New Home Warranty Corporation Stripped of Responsibilities by Ontario Government

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Toronto Star: “Province Stripping Tarion of Builder-Regulator Role” (March 28, 2017):

https://www.thestar.com/news/investigations/2017/03/28/province-stripping-tarion-of-builder-regulator-role.html.

 The Globe and Mail: “Ontario to replace Tarion with new regulator for home builders” (March 28, 2017):

http://www.theglobeandmail.com/real-estate/ontario-to-replace-tarion-with-new-regulator-for-home-builders/article34465468/.

Ontario New Home Warranty Regulator Reviewed

Tarion was created in 1976 to protect new home purchasers by extending warranty coverage under the Ontario New Homes Warranties Plan Act. Tarion’s responsibilities include regulating homebuilders and vendors, administering new home warranties and setting warranty terms, investigation warranty claims, resolving disputes between homeowners and builders or vendors, and prosecuting illegal builders. Tarion also administers the Guarantee Fund, a financial reserve designed to protect consumers from potentially catastrophic building events. Continue reading “Tarion New Home Warranty Corporation Stripped of Responsibilities by Ontario Government”

The Silver Tsunami: Regulating Aging Professionals

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The Grey Tsunami – Regulating Aging Professionals 2

I’ve always been fascinated by, and have worked extensively in the area where professional practice intersects with health problems. A particularly relevant challenge for professional regulators is managing the wave of aging baby boomers who are now at retirement age but who continue to practise.

This is a version of a presentation about aging professionals I’ve given a couple of times.

 

Moneyballing Criminal Justice

TED Talk – October 2013

Anne Milgram, Former Attorney General of New Jersey

For a companion piece to Malcolm Sparrow’s book Handcuffed: What Holds Policing Back, and the Keys to Reform (see my review in the preceding post), take a few minutes to watch this fascinating TED talk from a criminal justice reformer who is renewing the drive to use data analytics to make better decisions in the U.S. criminal justice system. And in keeping with Sparrow’s message of collaboration, I would strongly encourage regulators to pay close attention to strategic advancements in the criminal justice system. There is much mutual learning to be had.

Anne Milgram is a former criminal prosecutor and Attorney General of New Jersey (2010-13), who has since moved on to found the Criminal Justice Initiative at the Laura and John Arnold Foundation.

Continue reading “Moneyballing Criminal Justice”

Handcuffed: What Holds Policing Back, and the Keys to Reform: Book Review

Handcuffed: What Holds Policing Back, and the Keys to Reform

Malcolm K. Sparrow

Brookings Institution Press, Washington, D.C., 2016

It is hardly news that America’s police forces are struggling with their mission. The recent spate of high-profile police killings and resulting riots have raised serious concerns about institutional racism – leading to the formation of the Black Lives Matter movement – a situation exacerbated by the ongoing war on drugs and the increasing militarization of U.S. police forces since 9/11. [1]

When it comes to the problems of U.S. police departments, Malcolm Sparrow’s unique background lends particular credibility to his views. A mathematician, former police officer, and professor in public management at the Harvard Kennedy School, he has the practical, analytical, and strategic insights needed to effectively guide police in their community and problem-solving work – if only he could find a receptive audience.

Handcuffed – in a nutshell – is a lucid, compelling plea by the author for U.S. police to re-dedicate themselves to their core work of harm reduction, through community and problem-oriented policing.

Continue reading “Handcuffed: What Holds Policing Back, and the Keys to Reform: Book Review”

It’s 2017. Do you know what your regulatory model is?

Regulators are very busy people.

Whether you’re a regulatory executive, an operations manager or front-line staff, your hands are full with the daily business of overseeing your charges: of licensing, investigating or disciplining professionals; of inspecting or enforcing against businesses; of monitoring the members or businesses within your mandate.

It can be hard to find the time to step back and really think about your business, and the way you’re going about it.

You’ve probably developed key performance indicators that you report to senior management, the board, and the public. Along with these, you may monitor other reports, such as benchmarks, turnaround times, workload reports, and task reports. You may have undertaken surveys of your stakeholders, to determine their awareness of and satisfaction with your work. You may have undertaken process reviews to improve operational efficiency. If you’re an executive or manager, you are keenly aware of your budget and resource constraints, and the pressure to do more (a lot more, no doubt) with less.

Ask yourself the following questions.

  • Is your enabling legislation very prescriptive about your regulatory actions, leaving you without much discretion to determine how best to conduct your regulatory work?
  • If not – how do you determine where to allocate your resources, and how to prioritize your work?
  • What role, if any, does the control of risk to the public play in your daily work?
  • Does your organization consider itself to be primarily an enforcer of regulation? Or do you also work with your regulated members or businesses to enhance their compliance?
  • Do you take into account the responsiveness and attitude of the regulated member or business in determining a regulatory course of action?
  • What role do other entities (such as other government, other regulators, community agencies, professional associations, etc.) play in your work?

The fact is – there is no one right way to go about your regulatory business. But that does not mean you don’t have to think about and apply strategy to your work.

Thankfully, many great minds have pondered these questions. In an upcoming post, we’ll talk about some of the operational models that have been developed, including:

  • Right touch regulation
  • Risk-based regulation
  • Smart regulation
  • Responsive regulation
  • Really responsive regulation
  • Problem-oriented regulation