The role of the College of Midwives of Ontario is to set standards of education, training, conduct and performance necessary to ensure that clients receive high quality midwifery care. Our regulatory activities are driven by our duty to act in the public interest, meaning that we put public at the forefront of all of our work. Our mandate and vision reflect this, as does our Strategic Plan and the associated strategic priorities.
In our 2017-2020 Strategic Plan, we identified Public Participation & Engagement as one of our strategic priorities.
Excerpt from the 2017-2020 Strategic Plan
Public Participation & Engagement
How we will achieve it:
- Inform and educate the public regarding the College’s role and how we fulfill our public protection mandate
- Adopt an effective public engagement program that allows active public participation and engagement, and provides sufficient opportunities for the public to impact decisions
How we will measure our success
- Information on the College’s role and its public protection mandate is published in an accessible format with consistent messaging
- The searchability of the public register is enhanced
- The College is an accessible resource to the members of the public
- Public engagement initiatives and activities are targeted and mutually beneficial
- Increased public involvement in the College’s governance arrangements and in the design of our regulatory work.
To help us achieve our priorities, and to make sure we are regulating appropriately in the interests of the public and clients of midwifery services, we have developed a strategy around public participation and engagement. This strategy sets out the principles and model we will work to starting from 2018 onwards.
Our governing legislation, The Regulated Health Professions Act, 1991 (RHPA) outlines a few engagement requirements of all health regulatory colleges in Ontario. Currently all Colleges are required to:
- Have public representation on the College Council. The Midwifery Act, 1991, for example, stipulates that the Council should be composed of at least five and not more than seven members appointed by the government.
- Have a website through which the public and members can access information about our programs and about registrants, including their registration history and professional conduct.
- Ensure college council meetings are open to the public and all Council meeting materials are posted on the website.
- Circulate to every member proposed regulations and certain by-laws for a period of at least 60 days before they are approved by the Council.
Beyond these mandatory requirements, the RHPA colleges do not have any legislative obligations with respect to public engagement.
It is common for regulators to supplement the legislative requirements by other methods to promote client and public engagement. At the College, for example, we engage with the public in the development of guidance and standards. Other methods used by regulators include commissioning quantitative or qualitative research, holding online discussion forums or conducting “customer service” surveys. Some of the Ontario regulators, such as the College of Physiotherapists of Ontario, established their own advisory groups, comprising clients and members of the public. While having such groups have obvious benefits, such as having available a pool of trained people who can be drawn upon at short notice, some drawbacks were highlighted as well. These groups are relatively expensive to establish due to recruitment costs, and require comprehensive orientation and regular guidance.
Whatever the form and level of participation, public engagement requires careful planning and implementation. As the regulator of the midwifery profession in Ontario, we need to be proactive in seeking out information from the consumers of midwifery services. A clear strategy will help us identify client needs and concerns, their experiences of using midwifery services, and their requirements for information, and allow us to be able to respond and regulate accordingly.
What is Public Engagement?
Public engagement is a process of actively bringing the voices of the clients and the public into decisions that are relevant to them. The decisions may be relevant to the public either because they have an interest in the issues being discussed, or because they are directly affected by the decision being made. Regardless of the motivation, the key to good engagement is giving people who want to contribute the opportunities to do so. Public engagement may consist of a wide range of activities from informing to participation. We have adopted a ladder of engagement model (see below) to outline what is involved in each level.
For the purposes of our plan, when we refer to the public we are largely referring to midwifery clients and their families, as well as any other interested parties who are not practising midwives nor midwifery stakeholders.
We anticipate that the College, and the public, will benefit from increased public engagement in the following ways:
- Better awareness of the College and its role will give midwifery clients greater knowledge about what to expect when visiting a midwife.
- Members of the public will know that the College is a resource for them, and be more likely to know that they can call the College with questions and concerns.
- The College will be able to craft better and stronger policies with public input.
- The public will have greater trust in the College, and be confident in our ability to make fair and consistent decisions.
- The College will be more accountable to the public through inviting members of the public to take a larger role in decision making.
Principles of Public Engagement
The below core principles will guide our work and decisions around public engagement. We will consider each principle as we develop a plan of activities and implement the strategy.
- We know who we are engaging and why
- We make use of existing networks and expertise
- We make sure engagement is meaningful and mutually beneficial
- We make it easy for people with a diversity of backgrounds and experiences to participate
- We listen and provide timely feedback
- We are cost-effective in our resource allocations and ensure value for money
- We are able to demonstrate that our outcomes are consistent with set expectations
Ladder of Engagement
We will be using the model of a “Ladder of Engagement” in order to build awareness and create connections with members of the public. A ladder of engagement is a commonly used tool in digital organizing, and was most famously used in Barrack Obama’s Primary and Presidential campaigns. This tool brings people in by first offering a small opportunity to engage with an organization, and then proposes further ways to be connected.
We propose to use this model to increase our public engagement, by focussing first on an awareness campaign, and then trying to turn that awareness into one-way information sharing, participation, and ultimately full collaboration.
The idea is to bring people together in a way that feels natural and organic. Through this method we should be able to reach members of the public who are interested in the work of the College and who want to be involved further. At any given point in time, there will be people on each rung of the ladder. For example, we currently have members of the public who are unaware that the College exists, some members of the public who are familiar with the College and who do give feedback to public consultations, and we have public members on the College’s Council whose decision-making role is integral to the College.
Some people will be content to stay at a particular stage in the ladder, but we will give opportunities for people to move up. To do this, we will rely on a number of tools. For the purposes of this strategy, we will group tools to match the four steps on our ladder of engagement. Some of the tools we may use are listed below, but this list is not exhaustive.
In order to inform and educate the public, and to allow for public engagement, we first need to build awareness about the College, and develop channels of communication between the College and the public. We can consider people to be on the “awareness” rung of the ladder when they know that the College is here regulating the profession.
We aim to increase awareness through posts on our website and social media. To achieve this, we may use social media advertising such as Facebook ads, Twitter promoted posts, Google Adwords, and Youtube ads. We will create content that is public-facing, and will use the 25th year of midwifery regulation (in 2018) as a draw. Through the Professional Standards for Midwives the College will also be requiring midwives to inform their clients about the existence of the College, which will help to increase awareness.
The next step on the ladder is information, which refers to one-way sharing of information from the College to the public. At this stage, a decision has already been made and we are not asking for the public to give feedback. Information sharing will lead to members of the public having a greater understanding of the College’s role, and members of the public will know that the College is a resource for them.
A member of the public who is on the “information” rung of the ladder could be signed up for social media pages and/or our electronic newsletter, and may engage with some of the content through “liking” the material posted. Someone else on the “information” rung of the ladder could be a midwifery client who is reading one of our brochures at a clinic. Many members of the public will stay on this rung of the ladder, one step above awareness.
We will share information with members of the public who have become aware of the College. Tools we may use include our “What to Expect with your Midwife” brochure, other public facing guides, a public facing newsletter that can be distributed to practices, and a more public focus to our website.
After awareness and information, members of the public can choose to continue to climb the ladder to participation. This refers to members of the public receiving our information and responding with their thoughts and feedback. Participation from the public helps us to be able to craft better and stronger policies, and through open and transparent consultations, the public will place greater trust in the College.
A member of the public is on the “participation” rung of the ladder when they are involved in a two-way conversation with the College. Being active with the College as a “participant” could include joining in public consultations, attending public meetings, or even sending feedback without being offered a prompt by the College. We may ask “participants” to let us know what other information we should be sharing with the public, whether we should be creating new guides, etc.
We will aim to manage “consultation fatigue” by ensuring that consultation that we do with members of the public is meaningful and adheres to the principles of public engagement listed above. All feedback received will be properly considered, and we will be clear in our response. Some members of the public may choose not to participate in a particular consultation if they feel that it is not immediately relevant, and we will make efforts to re-engage them in subsequent consultations. If consultation fatigue is becoming an increasing issue with members of the public on the “participant” rung of the ladder, we can consider segmenting our outreach to ensure we are only corresponding with people on topics they are most interested in. We will regularly assess this by looking at unsubscribe rates and feedback rates.
Collaboration refers to working together with the public, in an equally weighted relationship. Currently, members of the profession and members of the public work together in a collaborative relationship in the College’s Council, with both midwives and appointed members determining the direction that the College will take.
A member of the public will have a collaborative relationship with the College when they become a decision maker, or a person who works as an equal partner to create something with the College. This will show the public we are fully accountable to them and adds an additional layer of transparency to our processes.
Members of the public who have participated in College activities and given feedback become part of a core group that we can consult with and share news of our activities with. We can rely on these individuals to be informed as we will be regularly sharing information with them through tools like our email list, social media, and public forums. These individuals may choose to become “collaborators” by applying for College Council and committees as appointed council members or non-council public members. We may also invite members of the public to join advisory working groups for particular issues and projects.
Public Engagement Action Plan 2018-2020
The first year we will focus on increasing the number of members of the public that we reach. That will include increasing our number of “likes” on Facebook, “follows” on Twitter, and increasing the number of email addresses we have to send our public email newsletters to. We will build awareness about the College and share information with the members of the public we reach. Through increasing our network, we will be able to reach exponentially more people, as it becomes much easier to use social media advertising to reach “friends of friends.” We will also be considering adding non-council public members to existing College committees after June 2018, subject to Council approval.
In the second year, we hope to use the awareness we have gained to work with the public to identify improvements, and ask for feedback on consultations and guides we may be creating. We will also pilot a couple different tools for engagement to assess their effectiveness. We will continue to increase awareness.
By the third year, the College will have regular and established public engagement, continuing to use the tools that were proven successful, and increasing awareness.