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CMPA Strategic Plan 2011 - 2015


Introduction

For over a century, Canadian physicians have relied on the Canadian Medical Protective Association to protect their professional integrity. The CMPA has been a consistent source of strength for its members and it has enabled physicians to practice medicine with confidence.

The Canadian health care system is facing unprecedented pressures. An aging population, an increasing demand for care, new delivery methods and accompanying additional responsibilities, resource constraints, emerging technologies, and continuing health human resource shortages all contribute to these pressures. Within this context, it is important to maintain an effective medical liability system that:

  • Provides appropriate compensation for patients proven to have been injured through negligent medical care.
  • Supports medical risk reduction aimed at preventing adverse events.
  • Holds physicians accountable for their actions while respecting procedural fairness.

The Canadian medical liability system has proven its effectiveness. However, past achievements do not necessarily guarantee future success and the CMPA is committed to ensuring its current and future members can practice medicine with the same confidence as previous generations of Canadian physicians. As physicians' professional requirements change, the Association will evolve its services to meet those needs.

The CMPA remains guided by the founding objects of its 1913 incorporation:

  • "To support, maintain and protect the honour, character and interest of its members.
  • To encourage the honourable practice of the medical profession.
  • To give advice and assistance to and defend and assist in the defence of members of the Association in cases where proceedings of any kind are unjustly brought or threatened against them.
  • To promote and support all measures likely to improve the practice of medicine."

This Strategic Plan reiterates the Association's commitment to its members and describes how the Association will respond to the changing health care and medico-legal environments and to physicians' evolving needs. It recognizes the medical liability system is an important component of the larger health care system and it reinforces the CMPA's commitment to an effective and sustainable system that balances accountability, compensation and risk reduction.

While the protection of its members remains the Association's primary role, this Plan also reflects the CMPA's ongoing contribution to the safety of medicine. It recognizes the CMPA can, within the boundaries of its expertise and both independently and in collaboration with others, identify opportunities for improved medical practice. This undertaking entails a commitment to sharing knowledge with members and stakeholders.

The Strategic Plan recognizes the Canadian medical liability system is vulnerable to financial pressures and it reiterates the Association's commitment to the responsible stewardship of the resources entrusted to it by its members. It also demonstrates the CMPA's support for sound public policy that sustains future generations of Canadian physicians and their patients.

This Strategic Plan describes the CMPA's mission, renewed vision and the five Strategic Outcomes that will carry the Association forward into the future. Implementation will be achieved through the annual operational plan and will be monitored through the Outcome measures identified in the Strategic Plan and in the CMPA's Balanced Scorecard. The Association is committed to transparent reporting of its performance.

Mission
To protect the professional integrity of physicians and to contribute to a high quality health care system by promoting safer medical care in Canada.


Vision
The CMPA will be valued as a world class provider of medical liability protection, a champion of medico-legal risk reduction and recognized as an important contributor to the Canadian health care system.

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Core values

The CMPA is owned and governed by physicians in the collective interests of the profession. The Association's core values guide its actions and fall within three broad commitments:

Commitment to members

  • Mutuality. The CMPA is a not-for-profit, medical mutual defence
    organization in which costs and risks are shared among its physician members. This entails both collective responsibility to individual members and member responsibility to their colleagues.
  • Discretionary assistance. The CMPA's assistance is discretionary. The Association seeks to extend its help to members who experience medico-legal difficulties arising from their medical professional work.
  • An ethical defence. The integrity and professional reputation of physician members are two of their most valued assets. The CMPA provides members with an ethical defence and, in keeping with its approach of "defending the defensible," does not settle unsubstantiated claims for expediency or economic reasons.
  • Service excellence. The CMPA strives to provide its members with a broad range of relevant and high quality services, in a compassionate and non-judgmental manner. These services are available to members in both English and French.

Commitment to patients

  • Safe medical care. The CMPA contributes to improving the safety of care and reducing risks in medical practice by using its extensive experience and expertise to encourage safe medical practices.
  • Financial compensation. If patients are proven to have been
    harmed as a result of negligent medical care provided by a CMPA member, assistance will be available to compensate those patients in an appropriate and timely manner.
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Commitment to responsible governance and management

  • Responsible stewardship. The CMPA operates in accordance with sound governance and business management practices and prudently manages the resources entrusted to it.
  • Financial sustainability. The CMPA is responsible to members to ensure sufficient funds are and will be available to meet the liabilities incurred in their professional practice. As an embodiment of this responsibility, the Association will strive to retain a fully funded financial position.
  • A valued and effective workforce. The CMPA is committed to maximizing the human potential of its valued, talented and committed workforce.
  • A prudent approach to risk. The CMPA employs an enterprise-wide approach to risk management and it actively manages business and financial risk to contribute to the sustainability of the medical liability system.

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Strategic outcome #1 — Protecting members' integrity

Canadian physicians care for their patients, confident the CMPA will protect their professional integrity

The CMPA's primary function is the protection of its members and the Association is committed to providing high quality assistance, including advice and legal representation. To achieve this outcome, the CMPA will adapt its service model to the changing needs of its members, while balancing individual and collective interests. Inherent in this approach is the understanding that membership in a mutual defence organization entails a two-way relationship between the Association and its members.

Objectives

1.1 To sustain members' confidence that the CMPA will protect their professional integrity
Canadian physicians trust the CMPA to provide them with high quality assistance, including medico-legal advice and, if required, legal defence. The CMPA will maintain member satisfaction through focused and effective execution of its core services.
1.2 To promote appropriate measures that encourage the timely resolution of medico-legal matters
Regardless of the circumstances, medico-legal matters are stressful for all involved: physicians, other health care providers, patients and their families. The CMPA will actively promote measures that respect the right to procedural fairness and encourage the timely resolution of such matters. This will reduce system costs, improve accessibility to justice and reduce the stress experienced by physicians and their patients.
1.3 To effectively and efficiently deliver services that meet member needs
The CMPA will deliver member-focused services effectively and efficiently, recognizing that, in serving the interest of all members, the wishes of individual members will not always be satisfied. The Association will leverage appropriate technologies to provide multiple service channels and improve member access to services in both English and French.
1.4 To adapt the CMPA's service offering to reflect the changing practice environment
As health care delivery evolves, so do the needs of members and, with the goal of addressing those needs, the CMPA will continually reassess its service offerings. Where appropriate, the Association will consider innovative solutions, including collaborative arrangements with other organizations.
1.5 To maintain access to high quality legal services
To meets its commitment to members, the CMPA engages high quality legal services. Working collaboratively with its General Counsel and Provincial Counsel firms, the Association will ensure appropriate legal advice and assistance is available to members.

Outcome measures

  • Member confidence levels in the CMPA's ability to provide effective medical liability protection
  • Member satisfaction with the overall scope and quality of CMPA services
  • Member satisfaction with legal services provided
  • Percentage of legal cases preceded by advice calls
  • Medico-legal case duration

Core activities

  • Medico-legal advice
  • Provision of legal assistance and representation
  • Case management
  • Membership administration
  • Contact centre operations

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Strategic outcome #2 — Reducing members' medico-legal risk

With the CMPA's assistance, Canadian physicians reduce their medico-legal risk

Physicians generally make every possible effort to protect their patients from harm. However, adverse events occur. The CMPA recognizes that proactively reducing a member's medico-legal risk contributes to decreased occurrence of adverse events, improved member and patient well-being, and lower costs. In addition, by appropriately addressing the medical and legal consequences of those events when they do occur, physicians can improve the outcomes for all involved. Inherent in the CMPA's mutual approach, it is expected members will take reasonable steps to reduce the medico-legal risk in their own practices.

Objectives

2.1 To prepare CMPA members to effectively respond to an adverse event
The CMPA will continue to enhance the ability of its members to respond to such events by addressing both the patient's needs and the medico-legal consequences. This will be achieved by educating members, prior to an event, about appropriate responses and by providing timely and accurate advice following an event.
2.2 To identify and promote practices that reduce members' medico-legal risk
The CMPA supports members by identifying and assessing medico-legal risks and promoting, both independently and in collaboration with others, practices that reduce or eliminate those risks. Reflecting the increasingly collaborative nature of care delivery, this information will be made available to all health care professionals through the Association's website and other appropriate channels.
2.3 To deliver services tailored to the medico-legal needs of individual members and groups of members
The CMPA recognizes that the needs of members differ and, when appropriate, it will tailor its services to assist identified members or groups of members in reducing their medico-legal risk. These needs-focused services may be delivered independently or in collaboration with other organizations.

Outcome measures

  • Member feedback on educational program effectiveness
  • Participation in CMPA educational offerings
  • Percentage of legal cases preceded by advice calls
  • Risk management collaborations with education and patient safety organizations

Core activities

  • Identification and analysis of the medico-legal risk factors
  • Collaboration with key stakeholders to identify changes aimed at reducing the medico-legal risk of members
  • Education of members to reduce their medico-legal risk
  • Provision of multi-channel access to the CMPA's risk reduction information and services

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Strategic outcome #3 — Contributing to safer medical practice

The CMPA makes a significant contribution to the safety of medicine in Canada

Creating the safest health care system possible is a common goal of health care providers, patients and governments. The CMPA has medical liability knowledge and expertise that can contribute, through risk reduction, to minimizing the number of adverse events. In so doing, the CMPA can tangibly contribute to safer medicine.

Objectives

3.1 To contribute to members' ability to prevent adverse events
Through its publications and educational offerings and within its medical liability expertise, the CMPA will continue to enhance members' awareness of preventative measures to reduce the possibility of adverse events. Where appropriate, such efforts will be conducted in collaboration with other organizations.
3.2 To provide a physician's perspective to system-level changes to reduce adverse events
Many adverse events result from a combination of system issues. Leveraging its medical liability expertise, the CMPA will collaborate with others to promote changes in systems and procedures aimed at enhancing the safety of medical practice. The CMPA's efforts will be focused on issues that directly impact physicians and their patients and that fall within its medical liability expertise.
3.3 To contribute to safer medical practice by identifying areas of medical risk
The CMPA will contribute to a reduction in the number of adverse events by identifying, assessing and communicating to selected partners areas of medical risk. This approach recognizes the CMPA's mandate does not extend to standard setting related to diagnosing and treating specific medical conditions.
3.4

To sustain the CMPA's knowledge generation and transfer capabilities
The CMPA holds medico-legal data that, with appropriate analysis and reporting, can provide useful insight into the safe delivery of care. Within the context of coherent information management and communication frameworks, effective knowledge generation and transfer capabilities support the Association's contribution to both reduced medico-legal risk and safer medicine.

Outcome measures

  • CMPA participation in patient safety and risk reduction initiatives
  • Support to standard setting and patient safety organizations in their efforts to improve clinical practice
  • CMPA credibility with key stakeholders related to safer medical care
  • Evidence-based research findings on medical risk

Core activities

  • Identification and analysis of adverse events
  • Collaboration with, and knowledge transfer to, key stakeholders to improve the safety of medical care
  • Education of members in risk reduction techniques

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Strategic outcome #4 — Supporting an effective and sustainable medical liability system

The CMPA is an important component of an effective and sustainable medical liability system

An effective and sustainable medical liability system is an important element of a well functioning health care system. The CMPA is committed to working collaboratively to encourage and support changes that enhance the effectiveness of the system and reduce overall costs. As an element of this commitment and within a financial model built on the retention of a fully funded financial position, the CMPA will continue to seek a transparent and predictable membership fee structure.

Objectives

4.1 To support public policy that contributes to an effective and sustainable medical liability system
Within its area of expertise, the CMPA will support, either independently or in collaboration with others, public policy initiatives that contribute to an environment in which physicians can practice medicine with confidence.
4.2 To contribute to the sustainability of the medical liability system by retaining a fully funded financial position
The CMPA will employ a business model that maintains member and public confidence in the sustainability of the medical liability system. Inherent in this approach is an organization-wide commitment to maintain a fully funded financial position. This commitment is based on the principle of inter-generational equity in which today's members pay for the liabilities incurred as a result of their practice. Expanded financial risk management and actuarial practices will support this objective.
4.3 To achieve stability of CMPA membership fees
The CMPA recognizes that predictable medical liability system costs, represented in part by CMPA membership fees, are an important consideration for members and for provincial/territorial governments. Acknowledging many costs are beyond its direct control, the CMPA is committed to achieving fee stability over time. Within the parameters of maintaining a fully funded position, the Association is prepared to proactively manage the organizational risk necessary to achieve this objective.
4.4 To promote reforms to the medical liability system that respect the rights of both physicians and their patients
The CMPA has long been committed to encouraging improvements to the medical liability system. Such improvements would improve the timeliness of resolution, enhance accessibility to justice, control costs and respect the rights of both physicians and their patients. Within its commitment to a just culture of safety, the Association will advocate, both independently and in collaboration with others, for appropriate reforms.
4.5 To effectively manage the CMPA's investment portfolio
On its members' behalf, the Association holds assets towards current and future liabilities. The CMPA will effectively and prudently manage these assets in a manner that safeguards the interests of members while contributing to the sustainability of the medical liability system.

Outcome measures

  • Impact of CMPA public policy efforts and submissions on system reforms
  • CMPA financial position
  • Long term fee stability
  • Investment performance

Core activities

  • Stakeholder engagement
  • Environmental scanning
  • Policy research, analysis and development
  • Strategic communications
  • Investment and portfolio management
  • Liability management, including claims trends analysis and forecasting
  • Fee setting
  • Management of reimbursement arrangements

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Strategic outcome #5 — Exercising responsible governance and management

The CMPA employs ethical, effective and accountable governance and management practices that fulfill the expectations of members and stakeholders

Members and key stakeholders entrust the CMPA with important responsibilities, and maintaining this trust is a prerequisite for organizational success. This requires effective governance and leadership, strong accountability frameworks, a value-based culture and a commitment to open communications. The CMPA is committed to governance and management practices that bear the scrutiny of members and stakeholders and support sound enterprise risk management.

Objectives

5.1 To instill member and stakeholder confidence through results-based reporting
Members and stakeholders expect to be able to evaluate the Association's performance and the CMPA will meet these expectations with robust corporate reporting.
5.2 To employ sound governance and management practices
The CMPA will continue to employ governance and management practices that ensure the Association is well positioned to meet its responsibilities. This includes further enhancing the Association's enterprise risk management and accountability frameworks.
5.3 To exercise responsible stewardship of CMPA resources
Members have entrusted the CMPA with the funds to meet future medico-legal liabilities and, in so doing, they expect responsible stewardship of those funds. The Association will continue to earn this trust by delivering services efficiently and managing operating, legal and other costs in a prudent and responsible manner.
5.4 To develop and retain a valued and empowered work force, fully capable of responding to organizational needs
Meeting the changing needs of members requires a talented and adaptable workforce that is committed to achieving organizational goals. The CMPA will maximize the human potential of its workforce, including empowering employees to make decisions within clear accountability frameworks. The CMPA will continue to pursue an approach that simultaneously builds on and develops the strengths of its current employees while seeking external talent when required. The goal is a diverse, knowledgeable, talented and committed workforce that can meet the challenges of both today and tomorrow.
5.5 To maintain an efficient and effective infrastructure
The CMPA requires an efficient and effective business infrastructure to meet the needs of its members. This infrastructure includes the facilities, information technology and business support tools necessary to achieve operational service goals. Infrastructure procurement and maintenance will be guided by sound resource stewardship principles. This approach recognizes members expect quality services that are delivered in a cost effective manner.

Outcome measures

  • Member and stakeholder confidence
  • Annual external audit results
  • Performance towards operational plan and budget
  • Governance evaluation results
  • Management practice benchmarking results
  • Employee engagement
  • Employee investment (continuing education, etc)
  • Systems reliability

Core activities

  • Governance and governance support
  • Strategic planning
  • Operational planning and budgeting
  • Audit and other oversight and review processes
  • Business process development
  • Performance measurement and corporate reporting
  • Enterprise risk management
  • Financial administration
  • Internal communications
  • Information management
  • Information technology services
  • Human resource management
  • Physical asset management

Strategic outcomes:

  1. Protecting members' integrity
  2. Reducing members' medico-legal risk
  3. Contributing to safer medical practice
  4. Supporting an effective and sustainable medical liability system
  5. Exercising responsible governance and management

" The CMPA is committed to ensuring current and future
members can practice medicine with confidence."