ISQUA16-2526GOVERNANCE STANDARDS FOR ABORIGINAL HEALTH SERVICES - A COLLABORATIVE JOURNEY

Abstract

Objectives: In an effort to better reflect the context and governance structures of Aboriginal Health Services (AHS) organizations, the Qmentum Governance standards were revised in collaboration with an advisory committee of representatives from the Aboriginal community. The new Governance for Aboriginal Health Services standards were developed in 2015 and released to clients in January 2016. Methods: Developing standards is a rigorous process designed to ensure that standards are measureable, relevant, evidence-informed and serve as effective tools for transforming knowledge to practice. This development process began with a scoping literature review, followed by focus groups to gather contextual knowledge related to governance structures in AHS organizations. The revision was further supported through convening an expert advisory committee with national representation from Aboriginal communities and surveyors to build consensus around the standards and language in a collaborative way. Next, a national consultation was held to obtain broad feedback on the revised standards prior to finalization. This feedback was incorporated and a final validation was performed with the expert advisory committee, prior to releasing the new standards in January 2016. Results: Several key findings emerged from the literature review, and focus groups: - The structures of Aboriginal governing bodies are highly variable and tend to be community-oriented rather than corporate in nature - Governance standards based on a traditional corporate (board) model may not fit the Aboriginal community context - Standards language and terminology should be culturally relevant As a result of these findings, several changes were integrated into the standards. Existing standards language was revised to better reflect the context of the Aboriginal sector, moving away from corporate-focused language, and embracing the community nature and values of the health organizations. The glossary and the guidelines in the standards were revised to use language and examples relevant to the Aboriginal health service sector and include concepts such as cultural safety. Further, the expert advisory committee suggested that the application of the standards should be flexible for different types of governance structures, and as a result, a customization feature was developed to tailor the standards to the context of the specific health organization being surveyed. Conclusion: The revision of Governance standards using a rigorous process of research and consultation with experts has resulted in a product, new Governance for AHS Standards, which is more inclusive and culturally relevant for AHS organizations. The new language and collaborative process of development was critical in achieving a product that is client-centred. Respect for cultural traditions and values and the concept of cultural safety are key elements for this sector that are now built into the standards. Accreditation Canada will continue to work with Aboriginal clients to build capacity in their organizations and communities by offering products that are developed collab-oratively and are culturally appropriate.