Canada - English


  • Type: Press release
  • Date: 2/6/2014

Clinical governance critical to delivering high-quality Canadian healthcare 

TORONTO – February 6, 2014


KPMG report reveals quality and safety key challenges for most hospital boards


Healthcare treatment should be seamless and error free, but recent cases show that does not always happen. Things can go wrong and healthcare leaders need to provide answers and explanations.


KPMG's report on hospital leadership: The more I know, the less I sleep - Global perspectives on clinical governance, reveals how many health systems are still rooted in craft-based practices and must embrace new, process-based methods to radically improve the quality of care in healthcare institutions.

The healthcare sector is now examining other industries and solutions to ensure it provides the best treatment to patients and avoids suffering and higher costs. The aim, in high risk environments like healthcare, is to become a 'high reliability' provider, focused on consistently excellent outcomes as well as the prevention of failure.


High reliability providers successfully align leadership, core processes and measurement systems with clear lines of accountability and a common mindset from the hospital floor to the boardroom.


Once hospitals reliably measure and report outcomes and show improvements, there will no longer be a need to publicly report an excess of processes and intermediate measures. Stakeholders will no longer be focussed on patient-centred practices, timeliness and effectiveness. Their focus will shift to confirming if providers are delivering the best possible outcomes.


Key report findings:


  • In some hospitals, poor or average practices have become the norm. This leads to a continued series of incidents. To create a culture of excellence, the Board should exercise 'zero tolerance' for low standards and challenge clinicians and administrators.
  • Measurements should be simpler, more relevant and systematic, focussing on what is important to patients; namely survival and quality of life. New and a smaller set of measures should make it easier to assess whether an organization is in control of quality.
  • The collection and presentation of healthcare data lags behind that of financial data, with a need for firmer guidelines, standardized procedures, and segregation of duties between recording and reporting.
  • Safety is a headache for public reporting, as negative outcomes are often too rare to be statistically valid. The report states that certification is the way forward, as it assures common standards across all providers, with accreditation schemes emerging in a number of countries.




"Smart healthcare providers will view issues in their service delivery as an opportunity to examine their procedures and implement improvements. Introducing and following the appropriate protocols, standards and measurements allows hospitals to focus on quality service and delivery, improving treatment for everyone involved, including patients, physicians and hospital leadership."


"The prevalence of high-profile incidents in healthcare has put the quality of patient care under the microscope and pinpoints the outdated, inadequate approaches of most healthcare organizations. The time to act is now, to ensure that internal and external measurements and reporting converge around what is best for the patient. Common standards are a priority, to enable meaningful comparisons at the national and international level. Governance is the critical glue that can bring together delivery and assurance, creating greater reliability over, and greater assurance of high quality outcomes."





About KPMG

KPMG LLP, an Audit, Tax and Advisory firm ( and a Canadian limited liability partnership established under the laws of Ontario, is the Canadian member firm of KPMG International Cooperative ("KPMG International"). KPMG member firms around the world have 155,000 professionals, in 155 countries. The independent member firms of the KPMG network are affiliated with KPMG International, a Swiss entity. Each KPMG firm is a legally distinct and separate entity, and describes itself as such.



Briana D'Archi
National Senior Manager, Communications
KPMG in Canada
416 777 8169


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Georgina H. Black

Georgina H. Black

National Industry Leader, Health & Life Sciences


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