“We welcomed the audit as an opportunity to help us identify strengths and opportunities to improve,” said Richard Ernst, President and CEO. “All hospitals in the report, including us, had gaps in how well they managed the use of consultants.” 

In particular, GGH needed to improve its processes with regards to sole sourcing (the awarding of contracts without having a competitive bidding process) and follow-on agreements (extending existing contracts without a full review beforehand).  

More recently, the Hospital has implemented a new, well documented, process for how it buys things, including consulting services. Among other things, its process requires Directors to document and justify their needs prior to obtaining senior management approval. In addition, all consulting engagements will have contracts with clear deliverables, ceiling prices, payment schedules, and performance management processes identified.

“The Auditor General report doesn’t question the need to use consultants, just the manner in which they are managed,” Ernst said. “Healthcare is very complex and consultants provide an important service to hospitals as we don’t always have the expertise on staff.”

For example, some of the recent ways GGH has invested in the knowledge and experience of consultants include:

• Targeted clinical reviews of departments to ensure quality of care and efficiency
• Implementation of IT projects which improve efficiency, patient safety and quality of care
• Training and education expertise (e.g. leadership development)
• Physician and executive recruitment
• Environmental assessment

The report provides guidelines about best practices in engaging consultants. GGH has already made improvements to its policies and procedures in this area and now meets or exceeds the guidelines.

In addition, the report recommends that hospital boards play a more active role in the oversight of the awarding of large contracts.

“To date, our Board of Commissioners has not expressed any concerns about management decisions to engage consultants,” said Board Chair, Peter Ferraro. “However, we will put processes in place to ensure our new policies and procedures are being followed and the Board is more involved in the oversight of consulting engagements.

“Our Board believes GGH is a very well managed organization. Through the fiscal challenges of the past years, we have managed to balance our budget and continue to provide the range of services our community requires. In fact, in the past two years we have added a regional Bariatric program and been designated regional provider of elective Vascular Services.”

GGH’s leadership is fully committed to taking action to improve public confidence in the management of taxpayer money.

Ernst said, “This latest report from the Auditor General will only help us be even more effective in managing our scarce resources while continuing to live our mission of providing quality, patient-centred health care.”