College Performance Measurement Framework (CPMF)

Overview

The Ministry of Health (ministry) is committed to building a connected and sustainable health care system centered around the needs of patients. The ministry formally launched the College Performance Measurement Framework (CPMF) in 2019 to assist in achieving these goals.

The CPMF was developed in close collaboration with Ontario’s health regulatory colleges, subject matter experts and the public. The CPMF provides information that is transparent, consistent and aligned across all health regulatory colleges on their performance in executing their public interest mandate.

The results will not be used to assess how well a health regulatory college is performing, rather, the information will identify commendable practices related to regulatory excellence and establish benchmarks for future reporting cycles, and where relevant, a health regulatory college’s performance improvement commitments.

Colleges have posted their CPMF Reports on their websites.

The ministry has prepared a Summary Report to highlight commendable college practices, areas where colleges are collectively performing well, potential areas for system improvements, and the various commitments colleges have made to improve their performance.

Links to the CPMF tool can be found here:

• 2023

Summary report: College Performance Measurement Framework

Introduction

Self-regulation of health professions in Ontario

In Ontario, the primary model for regulation of health professions is based on self-governance^{footnote 1[1]} The Regulated Health Professions Act, 1991 (RHPA) establishes 26 health regulatory c olleges that govern 28 professions in the public interest. Under the RHPA and profession specific Acts, colleges are responsible for ensuring their respective professions provide health services in a safe, professional and ethical manner. In order to practice in Ontario, regulated health professionals must be registered with a college.

Central to their mandate, colleges ensure that their registrants are skilled, qualified to practice, maintain their competence, comply with standards of practice and are disciplined, where necessary. They vary widely in size and resources, as well as in the scope of practice and controlled acts that members are authorized to perform.

The colleges are structured like corporations, with councils that function as a Board of Directors. College councils are comprised of members of the profession, who are elected by their peers, and lay persons who are appointed by the Lieutenant Governor in Council. Professional members make up 51% of the council with public appointees comprising 49%. Councils meet quarterly and meetings are open to the public.

Each council appoints a Registrar who is an employee of the college and functions as a Chief Executive Officer. The Registrar performs statutory duties outlined in the RHPA and is also responsible for managing the operations and overseeing college staff.

Colleges are financially independent from government and are financed through fees collected from their membership bases.

What the College Performance Measurement Framework is

The College Performance Measurement Framework (CPMF), was developed collaboratively by the Ministry of Health, health regulatory colleges, members of the public and subject matter experts. It is intended to strengthen the accountability and oversight of Ontario’s health regulatory colleges by providing publicly reported information that is transparent, consistent and aligned across all 26 regulators. Reporting performance on a standardized set of measures also enables Ontario’s health regulatory colleges to continuously improve performance by identifying and reporting on commendable practices among peers.

Colleges also report specifically on their registration processes through an annual Fair Registration Practices Report submitted to the Office of the Fairness Commissioner^{footnote 2[2]}. Additionally, colleges are required by legislation to publish annual reports that highlight their activities over the previous year. The only mandatory information that must be included in the annual report is an audited financial statement and the content of the reports vary from college to college. The CPMF is distinct from these reports and unique in that it provides a broad overview of the colleges’ governance and operations.

The CPMF has the following components:

• Measurement domains: Critical attributes of an excellent health regulator in Ontario
• Standards: Performance-based activities that a college is expected to achieve and against which a college will be measured
• Measures: More specific requirements to demonstrate and enable the assessment of how a college achieves a standard
• Evidence: Decisions, activities, processes, or the quantifiable results that are being used to demonstrate and assess a college’s achievement of a standard
• Context measures: Statistical data colleges report that will provide context about a college’s performance related to a standard
• Planned improvement activities: Initiatives a college commits to implement over the next reporting period to improve its performance on one or more standards, where appropriate

The CPMF has seven measurement domains that contribute to a college effectively serving and protecting the public interest. The measurement domains are:

• Governance
• Resources
• System partner
• Information management
• Regulatory policies
• Suitability to practice
• Measurement, reporting and improvement

What the ministry’s Summary Report is

This Summary Report (report) provides a system level overview of all 26 colleges’ self-reported results organized by measurement domain. The report highlights some commendable college practices, areas where colleges are collectively performing well, potential areas for system improvements, and the various commitments colleges have made to improve their performance.

The commendable practices included in this report were identified by a working group comprised of representatives from the colleges, the public and experts in performance measurement. For the purposes of this report, a commendable practice is defined as a system, tool or method intended to improve a regulatory practice. The working group reviewed all 26 reports against selection criteria to identify 52 commendable practices across all measurement domains. Selection criteria considered the following:

• importance to regulating in the public interest
• the flexibility/adaptability of the commendable practice
• the effectiveness/applicability to all health regulatory Colleges
• the efficiency of the practice

This report highlights the top six commendable practices identified by the working group. The Collective Strength sections of the report will also identify notable practices where colleges reported performing well.