Setting priorities in healthcare institutions: The case of McGill University Health Centre

Abstract

Priority setting is a decision-making process concerning the distribution of resources. The imbalance between allocated resources and public demand for health services as well as the inherent complexity of healthcare institutions are making priority setting one of the most challenging health management issues. Nevertheless, the priority setting processes and policymaking have not been studied very much at the hospital strategic planning level, i.e., the prioritisation of clinical activities. The purpose of this paper is to provide an evidence based case for improving the priority setting process in large hospitals. In a qualitative case study carried out at the McGill University Health Centre (MUHC), a priority setting exercise is described and the process is assessed in line with an accountability for reasonableness framework. Data collection involved in-depth, one-on-one interviews with key participants, review of key documents, and in-field observation. To assess the priority setting exercise, this paper compares the priority setting process against the five conditions of accountability for reasonableness, and identifies good practices and opportunities for improvement.