2015-2019 Strategic Plan

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THE CANADIAN MEDICAL PROTECTIVE ASSOCIATION
2015-2019 STRATEGIC PLAN
 
 
 
STRATEGIC OUTCOME 1
Assisting Physicians

Objectives
  • Protect members’ professional integrity
  • Assist physicians in reducing their medical liability risk
  • Provide services that meet membership’s evolving needs
 
STRATEGIC OUTCOME 2
Contributing to Safe Medical Care

Objectives
  • Reduce harm from medical care
  • Advance system level enhancements to healthcare delivery
 
STRATEGIC OUTCOME 3
Supporting the Medical Liability System

Objectives
  • Support an effective medical liability system
  • Retain full funding
  • Exercise sound governance and management
 

 
 
CORE VALUES
Mutuality Discretionary Assistance Ethical Defence Safe Medical Care Service Excellence Responsible Stewardship
 
 



Introduction

Since its founding in 1901, the Canadian Medical Protective Association has been committed to supporting, maintaining and protecting the honour, character and interest of its members. While the profession of medicine has changed dramatically during the past 114 years, the CMPA has remained resolute in its commitment to addressing, the medical liability protection needs of its members.

The CMPA is a not-for-profit, mutual defense organization in which the cost of medical liability protection is shared by its physician members. Within this construct, the Association assists members who face medico-legal difficulties arising from the professional practice of medicine. In turn, members are expected to practise in a manner consistent with the values of the medical profession and act in accordance with the existing obligations of the CMPA By-law and other obligations determined by the Association's member-elected Council.

A well-functioning healthcare system supports the availability of safe medical care for all Canadians, and effective and efficient medical liability protection is an essential component of such a system. When physicians are confident of their medical liability protection, they are able to deliver care in the most effective and efficient manner possible. An effective medical liability system:

  • Enables physicians to deliver care with the confidence their interests and those of their patients are protected
  • Contributes to safe medical care and the prevention of harm
  • Provides appropriate compensation to patients proven to have been harmed by negligent medical care
  • Holds physicians and other healthcare professionals accountable for their actions through a fair process

Several countries have experienced a breakdown of their medical liability system; one of the negative impacts of which has been a hindering of access to medical care. In contrast, Canada has benefited from an effective medical liability system that supports the delivery of safe care. In an increasingly complex and resource constrained healthcare environment, the provision of cost-effective medical liability protection in Canada has never been more important. As an essential component of the healthcare system, the CMPA enables physicians to confidently treat their patients, and identify and reduce risks in their practices. In the event a patient experiences harm from negligent medical care, the Association provides appropriate compensation.

The CMPA will continue to evolve its services to effectively and efficiently meet the changing medical liability protection needs of its members. As the healthcare environment changes, be it in response to resource constraints, evolving physician practice arrangements, demographic influences or other factors, so do physicians' liability protection needs. These protection needs include processes through which medico-legal issues are resolved in a fair and timely manner.

With a goal of supporting the safest possible healthcare system and in collaboration with its members and other stakeholders, the Association leverages its understanding of medical risk to contribute to safe care. With this Strategic Plan, the Association has undertaken to further increase its already significant efforts in this domain. The CMPA's goal is to substantively contribute to the prevention of harm in healthcare delivery. This benefits physicians, their patients, and the healthcare system.

An effective medical liability system must be sustainable, both in the short and longer terms. The CMPA is committed to working with others to address sustainability challenges, including championing sensible improvements that reduce overall system costs while appropriately respecting the interests of all parties. Inherent in this effort is a commitment to manage the Association's financial and human resources in accordance with sound governance and management practices. Recognizing its financial responsibilities and cognizant of its long-term obligations, the CMPA exercises effective stewardship over the resources members have entrusted to it.

The CMPA has over a century of success, founded in large part on its adherence to its core values and its enduring commitment to its members. Throughout its history, the Association has successfully evolved to meet changes in its environment and in its members' needs. While the CMPA is proud of its history, it understands that while retaining its core services, it must adapt to ensure it can deliver sustainable medical liability protection well into the future. The Association will retain its relevance to members and to the healthcare system by continuing to adapt to changing requirements. Members and stakeholders can take comfort in this long-term, forward looking perspective.

In a complex and dynamic environment, this Strategic Plan achieves the appropriate balance between continuity and change. It describes the Association's core values, mission, vision, and strategic outcomes and enunciates the objectives to be accomplished and the means through which success will be measured and reported. The Plan also identifies the high-level strategic change initiatives that will be implemented through annual operational and change management plans.

Core values

The Association is defined by its core values, which guide its actions and decisions on behalf of its physician members and reflect its commitment to an effective and safe healthcare system.

  • Mutuality
    The CMPA provides medical liability protection to its members while, in turn, members are responsible to their colleagues and to the Association to practise in a manner consistent with the values of the medical profession. Members are also expected to act in accordance with the existing obligations of the CMPA By-law and other obligations determined by the Association's member-elected Council.
     
  • Discretionary assistance
    The CMPA's assistance is discretionary and it extends appropriate assistance to members who experience medico-legal difficulties from their medical professional work.
     
  • Ethical defence
    The CMPA provides members with an appropriate and ethical defence and, in keeping with its philosophy of "defending the defensible," does not settle unsubstantiated claims for expediency or economic reasons. However, if patients are proven to have been harmed as a result of negligent medical care provided by a CMPA member, those patients will be compensated in an appropriate manner. The CMPA seeks to do this in as timely a manner as is feasible.
     
  • Safe medical care
    Within the context of a quality healthcare system and in collaboration with others, the CMPA is committed to enhancing the safety of medical care.
     
  • Service excellence
    Through its physician-to-physician assistance model, the CMPA provides its members with a broad range of relevant and high-quality services, in an empathetic and non-judgmental manner. These services are available to members in both English and French.
     
  • Responsible stewardship
    The CMPA operates in accordance with sound governance and management practices. It prudently manages the resources entrusted to it and is committed to optimizing the human potential of its valued workforce.

Strategic outcome #1 — Assisting Physicians

Canadian physicians care for their patients, confident the CMPA will effectively and efficiently protect their medical liability interests.

The CMPA is committed to providing high quality advice and assistance to members for medical liability difficulties arising from the professional practice of medicine. It offers a continuum of service that extends from education aimed at harm prevention, through to advice to guide members in responding to medical liability issues and when required, legal assistance to resolve such matters.

Through early engagement with physicians who may be experiencing medico-legal difficulties, the Association seeks to assist members in meeting their professional obligations in a manner that benefits them, their patients, and the medical profession. In keeping with the mutuality inherent in CMPA membership, members are responsive to the Association's efforts to assist them. In the event a patient has shown to have been harmed by negligent medical care, the CMPA will provide appropriate compensation on the physician's behalf. By meeting the societal need for effective medical liability protection, the CMPA is an essential component of the healthcare system.

Objectives

1.1 To protect members' professional integrity so they can confidently care for patients
Canadian physicians continue to trust the CMPA to provide them with high quality medical liability protection, including advice and, if required, legal assistance, in matters resulting from the professional practice of medicine. The CMPA is viewed as a trusted source of expertise and advice.
1.2 To assist physicians in reducing their medical liability risk
The CMPA supports members by identifying medical liability risks and promoting measures that reduce those risks and enhance the safety of care. This will be achieved by educating members about appropriate prevention strategies and responses to harm, and by providing timely and accurate advice following care in which harm has occurred.
1.3 To effectively and efficiently provide services that meet the membership's evolving medical liability protection needs
The CMPA delivers high-quality member services in an effective and efficient manner that, within its mutuality framework, meets the medical liability protection needs of most of its members. As the membership's protection needs change, and with a view to ensuring both continued relevance to members and the long-term sustainability of a medical liability system, the CMPA will adjust its extent of assistance model as required.


Strategic change initiatives

  1. Enhance the management of medical liability cases, including seeking earlier case resolution.
    In response to the changing medical liability protection needs of its members, the CMPA will continue to evolve the manner in which it supports members in need of assistance. Recognizing the specific circumstances of each matter, it will employ the most appropriate approach to achieve a fair and timely resolution. In so doing and while retaining high-quality services that meet members' needs, the Association will ensure the assignment of the most appropriate resources to the matter, including its complement of highly experienced medical officers.
     
  2. Develop mechanisms to more effectively support members in meeting their mutuality obligations.
    The CMPA will support members, particularly those whose medical liability experience is more extensive than their clinical colleagues, in accessing services that may assist them in meeting their professional obligations. Within the concept of mutuality, this will include the identification of members in need of additional assistance. Working with others, the CMPA will support the development of such assistance programs.

Outcome measures

  • Membership satisfaction with the quality and range of CMPA services
  • Membership confidence in the CMPA to appropriately defend them and compensate patients proven to have been harmed by negligent care
  • Members accessing risk management services
  • Medico-legal case frequency and severity in targeted risk areas
  • Claims frequency and severity for members participating in recommended risk management programs

Strategic outcome #2 — Contributing to Safe Medical Care

In support of a high-quality healthcare system, the CMPA contributes to safe medical care in Canada.

The CMPA is committed to employing its knowledge and expertise to contribute to safe medical care and the reduction in harm resulting from care provided by physicians. In so doing, it actively seeks to collaborate with other organizations to identify risks and their causes, and to develop and disseminate risk reduction strategies to its membership. This effort benefits physicians, patients and the Canadian healthcare system.

Effective risk and harm reduction requires a strong commitment from physicians and other healthcare providers. The Association recognizes physicians practice within a system of care and system level enhancements are essential in ensuring Canadians have access to safe, high-quality, and effective care. The CMPA actively supports the development and implementation of such enhancements, including supportive policies, programs, and practices that aim to reduce risk and harm. The CMPA contribution to risk and harm reduction and the advancement of system level enhancements to healthcare includes the appropriate sharing of data, analysis, and risk reduction strategies.

Objectives

2.1 To reduce harm from medical care
The CMPA substantively contributes to the reduction in the likelihood and impact of harm from care provided by physicians, through risk identification and the assessment of contributing and causal factors. In collaboration with others, the CMPA will support the development of, and promote, harm prevention strategies. This includes a focused approach on clinical issues and practices wherein the risk of harm is relatively high. By reducing the harm to patients, this effort benefits all Canadians.
2.2 To advance system level enhancements to healthcare delivery
The CMPA, working with others and within a system context that engages institutions and other healthcare professions, identifies, promotes, and measures the impact of changes that will enhance the safety of healthcare.


Strategic change initiatives

  1. Advance a system level approach to the prevention of harm from medical care.
    Leveraging its understanding of medical risk, the CMPA will pursue a system level approach to the prevention of harm from medical care. This will require significant collaboration with other healthcare organizations and will include the identification of effective harm prevention strategies and the dissemination of relevant information to the medical profession. The CMPA's efforts at the system level will be integrated with those at the member and/or practice unit level. This will require a concerted effort and commitment from physicians, other healthcare professionals, and organizations.
     
  2. Support the reduction of harm from medical care in high-risk practice.
    Building on an understanding of collaboratively identified areas of medical risk, the CMPA will undertake actions to reduce the likelihood and impact of harm. Such actions may include, among other initiatives, broad awareness campaigns, targeted educational efforts, knowledge transfer to clinical standard-setting bodies, and support to communities of practice.
     
  3. Collaborate with others to identify high risk medical practice.
    Independently and in collaboration with others, the CMPA will identify areas of medical practice with a high risk of harm. This will include the appropriate collection and sharing of data with like-minded organizations and the conduct of independently and jointly executed analysis. Identified areas of risk will form the focus of the Association's efforts in contributing to safe medical care.

Outcome measures

  • Reduction in patient safety incidents in targeted risk areas
  • Adoption of recommended revisions to clinical and practice standards and guidelines
  • Member and stakeholder assessment of CMPA effectiveness in contributing to safe medical care

Strategic outcome #3 — Supporting the Medical Liability System

The CMPA supports an effective and sustainable medical liability system that meets the needs of physicians and their patients.

By supporting the availability of physician care, an effective and sustainable medical liability system is an essential element of a well-functioning healthcare system. The CMPA is committed to working with members, medical and healthcare organizations, and governments to enhance the fairness and effectiveness of the system. It will seek collaborative approaches to contain medical liability protection costs and, with the goal of retaining a fully funded position, will maintain a transparent membership fee structure.

Objectives

3.1 To support an effective medical liability system
The CMPA supports, both independently and when appropriate with others, policy initiatives that contribute to an environment in which physicians can practise medicine with confidence, knowing their interests and those of their patients are protected and medical liability issues are resolved in a fair and timely manner. This includes measures that, while retaining fairness to all parties, support the long-term sustainability of the medical liability system by eliminating unnecessary costs and streamlining processes.
3.2 To retain full funding
With a view to supporting member and stakeholder confidence in the sustainability of the medical liability system and in meeting its financial obligations, the CMPA is committed to holding financial assets equal to its actuarially estimated liabilities (a fully funded position). This supports a business model in which today's members are responsible for the liabilities incurred in their provision of care. Being cognizant of the long-term nature of medical liability protection, the CMPA is committed to returning to and maintaining a fully funded position. The Association also recognizes members and stakeholders want CMPA membership fees to be generally predictable on a year-over-year basis. To the extent feasible, the CMPA shares this goal.
3.3 To exercise sound governance and management
The CMPA employs effective governance and management practices that reflect its essential role in the healthcare system. In support of system sustainability and recognizing its responsibility for the resources entrusted to it, the Association delivers services effectively and efficiently, and manages legal, governance, operating, and other costs in a responsible manner. It will report performance and financial results in a transparent and responsible manner that engenders member and stakeholder trust.


Strategic change initiatives

  1. Optimize the delivery of legal services, while retaining high quality assistance to members.
    Recognizing the evolving medical liability protection needs of members in a resource-constrained environment and while ensuring the timely and fair resolution of medico-legal issues, the CMPA will optimize the manner in which it provides legal assistance to members.
     
  2. Advance enhancements to civil justice, regulatory, and administrative processes that reduce medical liability system costs while protecting the interests of physicians and their patients.
    The CMPA will, working in conjunction with others, actively advocate for civil justice and regulatory and administrative improvements that enhance the financial sustainability of the medical liability system, and produce fair and timely resolution for physicians and patients proven harmed by negligent medical care.
     
  3. Strengthen internal operations and governance practices.
    In keeping with its commitment to effective stewardship of resources and to meet the evolving medical liability protection needs of members, the CMPA will continue to strengthen its operational and governance practices to achieve optimal value for money. In so doing, the CMPA will draw on the extensive knowledge and innovative thinking of its valued workforce.

Outcome measures

  • Impact of public policy submissions and engagements in support of selected advocacy campaigns
  • Aggregate CMPA system cost per member
  • Case durations
  • Ratio of total assets to total liabilities
  • Change in aggregate fees
  • Operating and governance costs per member
  • Employee engagement

Enterprise functions

The achievement of the CMPA's mission, vision, and strategic outcomes depends, in part, on effective governance and management functions. The CMPA aims to deliver these enterprise functions in the most cost-effective manner possible, recognizing the imperative for a value for money approach that reflects its commitment to a sustainable medical liability system.

In maintaining the capabilities and capacities necessary to meet its obligations to its members and to the healthcare system, the Association seeks to maintain the organizational resiliency necessary to respond to a changing environment and evolving member needs. This resiliency is based, in large part, in its experienced and talented workforce and its member-elected governance structure. In recognition of its increasingly dynamic environment, the CMPA will place added importance on retaining an adaptable and engaged workforce that fully leverages existing capabilities and develops innovative and cost-effective approaches to fulfilling the Association's mandate. 


Conclusion

The CMPA's 110 plus years of success have been founded on an unbending commitment to its members and this commitment is undiminished. The Association recognizes that, to ensure members can practise with confidence their medical liability interests and those of their patients are protected, it must evolve to meet the demands of an increasingly complex environment. It remains committed to its core value of mutuality in which it provides services to members who, in turn, undertake to practise in a manner consistent with the values of the medical profession.

This plan also commits the Association to making, in collaboration with others, a greater contribution to enhancing the safety of medical care. The CMPA believes that harm prevention is a system issue, one that requires a coherent and concerted effort on the part of healthcare professionals, institutions, governments, and others. Safe care is in the interests of all Canadians and the Association is fully invested in contributing to efforts to achieve this goal.

Canadians have benefited from an effective medical liability system in which physicians can confidently deliver care and in the event of harm from negligent care injured patients are compensated. Rising costs threaten the sustainability of this system and, in the interests of all Canadians, the CMPA will continue to advocate for sensible improvements that enhance system effectiveness and efficiency.

Physicians and their patients can be assured that, notwithstanding the challenges facing the healthcare system in Canada, the CMPA remains resolute in protecting their medical liability interests.