Big Changes Ahead: Our Governance Revolution

Our ability to protect the public starts at the top. This is why Council conducted a top-to-bottom review of its governance operations and structure. Council did this to make sure it was keeping pace with the public’s changing needs.

Council is the College’s governing body and sets the strategic direction for regulating nursing in the public interest. Both elected nurses and government-appointed members of the public sit on Council.

In addition to Council, the College has a number of committees that make decisions related to our public protection mandate. These include committees that focus on: complaints from the public, disciplinefitness to practisequality assurance and registration, and provide advice about financial matters.

What the public needs and expects from its regulators is always evolving. Therefore, our governing body must also continually evolve to best serve the public.

In 2014, Council took a bold step forward and invited an external task force to review all aspects of its governance — from the basics of how Council is formed, to how it operates. Council wanted a proactive, objective, expert and evidence-informed review that was completely centred on public trust.

The task force reviewed global governance trends, best practices and expert advice. It also shared how to apply these to the College’s governance. We published the findings and recommendations in a report called Final Report: A vision for the future. At its December 2016 meeting, the College’s Council approved this vision for governance.

At the March & June 2017 meetings, Council established a working group of five Council members to work with Council in developing a plan for implementing the governance vision. This included a plan for achieving the needed legislative change. The working group has been assisting Council to identify and implement advancements that can occur before legislative change.

Here are a few summarized highlights of just a few elements:

Council's size and shape
Currently, Council has 37 members, including 21 nurses and 16 members of the public. The future board (which will no longer be called Council) will have 12 members, and there will be an equal number of nurses and public members.

Why? Members of the public have an important part to play on our board. We also need nursing expertise to succeed. The new model will provide that balance and reflect the board’s commitment to the public.   

Multiple pieces of evidence say the same thing: smaller boards are more effective in making decisions. Large boards are generally more bureaucratic and less flexible. It's easier for members to share ideas in a smaller board.

Board appointments
Board members who are nurses will no longer be volunteers who are elected by their peers. Instead, they will be appointed based on specific attributes and competencies — their experience, knowledge, and skill.

Why? The decision to move from elections to appointments was a serious one. Ultimately, it was based on two things. First, elections create the potential for misunderstanding, because nurses elected to the governing body do not serve those that elected them — they serve the public. Second, appointments based on competencies ensure that the board is comprised of a diverse group of people with a wide range of expertise, skills, extensive knowledge and different perspectives.

Advisory groups
Under the new model, the board will create advisory groups as needed to help promote decision-making from a diverse range of perspectives.
Why? Advisory groups will bring yet another layer of expertise and knowledge to the board. They may be comprised of members of the public, various industry experts and nurses with expertise in specific areas such as mental health or remote nursing.

Evaluation
Every three years, an external expert will evaluate the board and its governance processes. The findings will be public.

Why? Our board wants to be a world leader in governance excellence. To do this, it needs to evaluate itself regularly so it can continuously improve. Evaluation also holds the governing body accountable to the public.

In September 2017, Council approved the milestones for implementing the vision. We’re going to pilot-test a new process for appointing 2019 statutory committee members. This involves defining what our committees will require and developing new educational resources about the College’s governance.

Later this year, nurses who are interested in applying to a committee can use the new competencies and resources.

Over the next two years, we will be providing regular updates about the progress. We encourage you to monitor developments, especially if you’ve ever been interested in serving on Council or a committee. Look for updates in this section and in The Standard.

To support the ongoing dialogue about the future of regulatory governance in Ontario and beyond, the College is making available the governance principles, vision, task force reports and supporting documents used to develop this vision:

Proposing change to protect the public

CNO has a bold, innovative vision to improve its governance. Vision 2020 will strengthen our protection of the public and enhance public trust in nursing regulation. CNO has submitted its vision for change to the Ontario government and requested the government make the legislative amendments needed for this improved model of governance. Together, we can advance regulatory excellence in Ontario.