Introduction
In January 2023, a competency based self-assessment survey was distributed to WECHU Board of Health (BOH) members. This survey was structured around twelve competency areas and was developed based on the Ontario Public Health Standards (OPHS) (2021), the WECHU BOH By-laws, and the Association of Local Public Health Agencies Board of Health Governance Toolkit. The purpose of this approach was to identify the strengths of the BOH, while also identifying opportunities to provide additional training and support. The OPHS (2021), under the Good Governance and Management Practices Domain, states: “the board of health shall have a self-evaluation process of its governance practices and outcomes that is completed at least every other year. Completion includes an analysis of the results, board of health discussion, and implementation of feasible recommendations for improvement, if any”.
The same survey was implemented in 2017, 2018, 2020, 2022 and again in 2023, allowing for a comparison of the data across years. Current BOH membership includes 10 members, of which 10 completed the 2023 self-evaluation competency survey.
Results
Competency Scores
There were 2 to 4 questions asked for each of the 12 competency areas. Average scores for each competency range from 0 to 4. The BOH average scores for each statement can be found in Appendix A. The overall BOH average score for each competency, along with the difference from the satisfactory and optimal range, can be found in Table 1.
The satisfactory response range (BOH average scores greater than 2, but below 3) reflects a score indicating that BOH members, on average, have the necessary competencies to successfully complete tasks related to that topic, but might require assistance from an expert at times.
The optimal response range (BOH average scores greater than or equal to 3) represents areas where BOH members on average are able to function most effectively, and are able to perform actions related to these topic areas without expert assistance.
Table 1. Competency scores
| Competency |
2020 BOH Average
(baseline) |
2022 BOH Average |
2023 BOH Average |
Difference from 2022 Average |
2023
Difference from satisfactory |
2023 Difference from optimal |
| Communication and Marketing |
2.67 |
2.67 |
2.81 |
↑0.14 |
↑0.81 |
↓0.19 |
| Community Partners and Stakeholder Engagement |
2.7 |
2.57 |
2.67 |
↑0.10 |
↑0.67 |
↓0.33 |
| Financial Management |
2.6 |
2.63 |
2.75 |
↑0.12 |
↑0.75 |
↓0.25 |
| Health Equity |
2.35 |
2.00 |
1.94 |
↓0.06 |
↓0.06 |
↓1.06 |
| Human Resources |
2.65 |
2.40 |
2.64 |
↑0.24 |
↑0.64 |
↓0.36 |
| Knowledge and Delivery of Public Health Programs/Services |
1.87 |
1.63 |
1.93 |
↑0.30 |
↓0.07 |
↓1.37 |
| Leadership and Governance |
3.08 |
3.10 |
2.94 |
↓0.16 |
↑0.94 |
↓0.06 |
| Legal |
2.1 |
2.07 |
2.11 |
↑0.04 |
↑0.11 |
↓0.89 |
| Performance Management and Quality Improvement |
2.65 |
2.45 |
2.33 |
↓0.12 |
↑0.33 |
↓0.67 |
| Political Acumen |
3.02 |
2.88 |
2.83 |
↓0.05 |
↑0.83 |
↓0.17 |
| Risk Management |
2.3 |
2.07 |
2.22 |
↑0.15 |
↑0.22 |
↓0.78 |
| Strategic and Operational Planning |
2.43 |
2.50 |
2.41 |
↓0.09 |
↑0.41 |
↓0.59 |
The overall average for 2023 was 2.47, which was slightly higher than the 2022 average of 2.42.
As shown in Table 1, average scores in 2023 were higher than those in 2022 for all but five competencies (Health Equity, Leadership and Governance, Performance Management and Quality Improvement, Political Acumen, and Strategic and Operational Planning).
Figures 1 and 2 are visual representations of the BOH average score on each competency compared to the satisfactory and optimal range. Scores for all but two competencies (Health Equity and Knowledge and Delivery of Public Health Programs/Services) fell into the satisfactory range, while no scores fell into the optimal range.
Figure 1. Average scores compared to the satisfactory and optimal range
Figure 2. Average scores compared to the satisfactory and optimal range (con’t).
Additional Comments and Suggestions
Lastly, members were asked if they had any further comments or suggestions. The themes of the comments included the request for more information regarding the future of the modernization of Health Units in Ontario, opportunities to make WECHU stand out amongst other Health Units, and more information on WECHU programs and services, namely Consumption and Treatment Services Sites (CTS) and the related regulations.
Overall Recommendations
- Provide training education sessions and e-learning modules to board members, beginning with those areas with the lowest scores (i.e., Health Equity, Knowledge and Delivery of Public Health Programs and Services).
- Provide quarterly opportunities to Board of Health members to provide feedback and recommendations in regards to Board of Health operations and decision-making to ensure continuous quality improvement.
Appendices
Appendix A: 2023 BOH mean scores for each statement by competency
| Item |
BOH Average |
Minimum |
Maximum |
| Communication and Marketing |
| Successfully communicating organizational messages to the media. |
2.78 |
1.00 |
4.00 |
| Representing the interests of an organization in the media. |
2.78 |
1.00 |
4.00 |
| Interacting with partners to promote programs/services. |
2.89 |
2.00 |
4.00 |
| Community Partners and Stakeholder Engagement |
| Identifying key partners/stakeholders. |
2.56 |
1.00 |
3.00 |
| Establishing strong partnerships with other organizations. |
2.78 |
2.00 |
4.00 |
| Resolving conflicts between partners/stakeholders. |
2.67 |
1.00 |
4.00 |
| Financial Management |
| Assessing financial information. |
2.78 |
2.00 |
3.00 |
| Managing a budget within an organization. |
2.67 |
2.00 |
3.00 |
| Creating innovative approaches to deal with fiscal restraints. |
2.67 |
2.00 |
3.00 |
| Re-allocating resources within an organization. |
2.89 |
2.00 |
4.00 |
| Health Equity |
| Identifying barriers individuals face when accessing public health services. |
1.89 |
0.00 |
3.00 |
| Consideration of health inequities in program/services decision making. |
2.00 |
0.00 |
4.00 |
| Human Resources |
| Assessing the work-related performance of employees. |
2.78 |
2.00 |
3.00 |
| Attracting and retaining employees. |
2.89 |
2.00 |
4.00 |
| Succession planning in an organization. |
2.56 |
1.00 |
4.00 |
| Addressing challenges in a unionized environment. |
2.33 |
0.00 |
4.00 |
| Knowledge/ Delivery of Public Health Prgms/Services |
| Integrating client/customer needs into programs/services. |
2.00 |
0.00 |
3.00 |
| Developing evidence-based programs/services. |
2.00 |
0.00 |
3.00 |
| Implementation of the Ontario Public Health Standards. |
1.78 |
0.00 |
3.00 |
| Leadership and Governance |
| Guiding an organization through change to reach their goals. |
2.78 |
1.00 |
4.00 |
| Leadership-level guidance of organizational operations. |
3.00 |
1.00 |
4.00 |
| Service on other boards or committees. |
2.89 |
2.00 |
4.00 |
| Decision-making that considers the impact on relevant stakeholders. |
3.11 |
2.00 |
4.00 |
| Legal |
| Managing organizational legal considerations. |
2.00 |
0.00 |
3.00 |
| Adhering to ministry required Board of Health legal obligations. |
2.22 |
0.00 |
3.00 |
| Applying ministry-level legal requirements in an organization. |
2.11 |
0.00 |
3.00 |
| Performance Mgmt and Quality Improvement |
| Supporting an organizational culture of continuous quality improvement. |
2.33 |
0.00 |
3.00 |
| Making organizational decisions based on the quality of programs/services. |
2.33 |
0.00 |
3.00 |
| Political Acumen |
| Advocating for the passing and enforcement of healthy public policies. |
2.44 |
1.00 |
4.00 |
| Identifying key players in the political decision making process. |
3.33 |
2.00 |
4.00 |
| Developing healthy public policies (e.g., analyzing, planning, implementing, and evaluating policy). |
2.56 |
1.00 |
4.00 |
| Understand the formal process for decision making at the municipal level. |
3.00 |
2.00 |
4.00 |
| Risk Management |
| Prioritization of risks to determine which should be addressed by an organization. |
2.33 |
0.00 |
3.00 |
| Documenting the cause and consequence(s) of identified organizational risks. |
2.11 |
0.00 |
3.00 |
| Identifying organizational risks. |
2.22 |
1.00 |
3.00 |
| Strategic and Operational Planning |
| Working towards organizational strategic priorities. |
2.44 |
2.00 |
3.00 |
| Monitoring progress towards meeting a strategic plan. |
2.44 |
2.00 |
3.00 |
| Development of organizational strategic plans. |
2.33 |
1.00 |
3.00 |
