Our mandate and core regulatory functions remain unchanged, but the landscape in which we operate and society’s expectations of midwives and of us as the midwifery regulator are changing. Midwifery practice is changing to adapt to an evolving health care system and to meet client needs. Navigating this landscape requires organizations to become increasingly informed by data to stay relevant, impactful and successful. Regulators, including the College of Midwives of Ontario, are under increased scrutiny to increase accessibility of information and openness in decision-making and to measure and publicly report on their regulatory performance, so that the public, midwives and our partner organizations understand our role and our value as the regulator.
Over the past four years, we have started a major transformation of our organization, moving from what was essentially a reactive model of regulation towards a risk-based model of regulation, one that seeks to understand risks better and to act quickly upon emerging concerns before they can negatively affect the public. Part of being a risk-based regulator means that strategic goals and subsequently proposed programs and our day-to-day activities are guided by focusing activity and attention on issues and potential risks that pose the greatest threat to our duty to protect the public.
We have made substantial progress during the past four years, and we are determined to maintain this momentum and launch into our new strategy cycle by responding to new challenges that, if not mitigated, have the potential to adversely impact our regulatory objectives and outcomes.
1. A need for greater agility in our regulatory processes to enable the evolution of the midwifery profession
Midwives’ careers are becoming more diverse. They are able to work in a wider range of environments than when the profession was first regulated. These changes require a renewed effort on our part to minimize the burden that some of our regulatory processes place on midwives whose contexts of practice do not allow them to meet our current requirements. This does not mean that the requirements we set should be lowered in ways that may compromise good midwifery practice and adversely impact client care. It does mean, however, that if we are to provide effective regulation, we must understand the context in which midwives work and to reassess our current framework to make sure that it allows the profession to evolve to meet the diverse needs of clients. Good regulation must be forward-looking and be able to adapt to change. It must enable such evolution, not be a barrier.
2. Managing and using the data that we collect
Data is a key enabler to our success, supporting our aim to be an agile, forward-looking regulator that operates efficiently. Our data strategy, implemented as part of our 2017-2020 Strategic Plan, focused on how we collect and manage data internally to measure and report on our regulatory work and performance. We completed this work successfully, however, technology and data analytics techniques have significantly evolved over the last four years. We now need to focus on how we can strengthen our analytics capabilities to help our decision-making and better identification and tackling of risks, to share data more effectively, and to streamline work across the organization to make us more efficient.
3. Managing increased expectations of information, openness in decision-making and demonstrating our value as the regulator
The public and practitioners that are subject to the decisions of regulatory authorities expect increased access to information to better understand the role of the regulator and the procedures that affect them. Without doubt, accessibility of information and transparency in decision-making are becoming more prominent as the public rightly demand to know more about our procedures to be able to better navigate our complex regulatory system. Similarly, midwives are asking for more information, analysis and insight to help them understand our requirements and procedures. These expectations require that we invest time and resources to transform the way we communicate and to make our information more open and accessible.
All these issues and changes present significant challenges but also create valuable opportunities for us to increase the impact of our work. We will work to understand and respond to these challenges so that we can continue to keep the public safe and to support the midwifery profession as it evolves and adapts to new realities.
Our Strategic Priorities
To achieve our ambition of further developing and maintaining a model of regulation that is agile, responsive and proactive, over the next 5 years we will focus on three strategic priorities:
- Regulation that enables the midwifery profession to evolve
- Effective use of data to identify and act on existing and emerging risks
- Building engagement and fostering trust with the public and the profession
The activities and objective in the following pages describe in detail the key initiatives through which we will achieve our strategic priorities and will measure our success. Some activities we have already started; others require discussions with our partners before we can decide how and at what pace they should be taken forward.
STRATEGIC PRIORITY 1
Regulation that enables the midwifery profession to evolve
Develop a responsive regulatory framework, without relying on legislative change, to ensure that all midwives, regardless of midwifery practice model, individual practice environment, or practice setting, are qualified to deliver good practice.
How we will achieve it:
- We will continue to develop and implement our plans for introducing an assessment program for midwives who are not able to demonstrate ongoing clinical currency and for non-practising midwives returning to practise. This will ensure that midwives have an alternative route to demonstrate the required clinical competence if they are not able to meet the criteria set out in College regulations.
- We will identify remedial and educational programs to address knowledge and skills gaps in midwives who have undergone an assessment or been the subject of an investigation. By intervening early, we aim to reduce the risk of more serious issues and regulatory action later on.
We will know we have been successful when:
- Irrespective of legislative change, our regulatory framework is designed to enable the midwifery profession to evolve and supports the use of early and proportionate regulatory interventions targeted to areas of greatest risk.
- We have greater assurance that midwives who successfully completed a competency-based assessment are fit to practise.
- We have increased confidence in our ability to facilitate midwives’ learning needs, from continuing professional development to remedial needs.
- We are recognized as regulating in a way that is responsive to the evolution of midwifery practice that better meets the needs of the public.
STRATEGIC PRIORITY 2
Effective use of data to identify and act on existing and emerging risks
Make better use of data about midwifery practice to identify, analyze and understand trends and areas of risk to the public to be able to maintain an effective system of regulation.
How we will achieve it
- We will gain a better understanding of clients’ needs and expectations across the range of settings in which midwifery care is provided and through analysis of internal College data. This will enable us to engage constructively with the profession to address clients’ expectations and find solutions to the issues which lead to complaints by setting new standards or providing regulatory guidance.
- We will enhance our data capabilities so that we better understand our registrant population, their practice environments, challenges they face, and the emerging risks to and opportunities for safe and ethical practice. This will help target our regulatory activities where they add most value in supporting good practice and act upon critical issues that present a risk of harm to clients.
- We will build on our engagement with midwifery and other regulators and partner organizations to share data and information effectively and to identify shared concerns. We will explore ways to formalize such information and data-sharing with our key partners which will commit us to collaborating to support each other’s goals.
- We will publish insights drawn from our data on a range of identified themes affecting midwifery practice and client safety with the goal to inform and improve practice.
- We will create data management strategies and systems including digitization of all appropriate records to ensure that data resources are easily accessible and effectively structured and managed, and that we are retaining and disposing of data assets in a sustainable and appropriate manner.
We will know we have been successful when
- We effectively use data to underpin decision-making and determine regulatory risks and mitigating strategies.
- We have a better understanding of clients’ needs and their expectations of midwifery practice and of factors that affect midwives’ ability to deliver the best care to clients, and as a result our work addresses these identified areas.
- Shared data and insight contribute to a fuller understanding of, and response to, risks and trends within the profession and the healthcare sector.
- We have a secure information infrastructure in place to ensure that records are systematized and readily accessible.
- We have enhanced analytical capabilities and there is internal understanding of the value of data, how to contribute effectively to its collection and use, and how it benefits our work.
STRATEGIC PRIORITY 3
Building engagement and fostering trust with the public and the profession
Deliver services and demonstrate our role and value as the regulator through greater engagement, openness and accessibility so that the public and the profession have confidence that we fulfill our public protection mandate effectively, efficiently and fairly.
How we will achieve it
- We will present information in a format that is accessible and allows the public to understand the College’s role, what it means to regulate in the public interest, how our complaints and discipline processes work, and how we make decisions that affect them.
- We will continue to engage with midwives to improve the transparency of our regulatory processes and decision-making. We will continue to make information about our ongoing requirements, standards and guidelines available to midwives in an engaging and accessible format.
- We will introduce orientation workshops to help midwives who are new to practice, or new to the province, to understand professional issues that will affect them on a day-to-day basis and what it means to be a regulated professional in Ontario.
- We will continue to work with our midwifery education partners to incorporate regular workshops on professional regulation into their curriculum with the purpose of educating midwifery students about their professional obligations within the Ontario system of regulation and preparing them for entry to practice.
- We will survey the public, midwives and midwifery students to track their perceptions of the College of Midwives of Ontario so we can better understand the impact of our work and how we can communicate more effectively with them.
- We will publicly report on our regulatory performance on an annual basis.
We will know we have been successful when
- We have a strategy in place that supports public access to information about the College’s public protection mandate and how to navigate our systems, including the complaints and discipline processes.
- Midwives understand College and other regulatory requirements and are informed about our processes and likely outcomes when they are subject to a College proceeding.
- Midwifery students in their final year recognize the role of professional regulation in supporting good midwifery practice and the duties and expectations of regulated professionals.
- Our feedback surveys record improvements in understanding of the work of the College.
- We show improved regulatory performance.