Debate Setting priorities in health care organizations : criteria , processes , and parameters of success

Background: Hospitals and regional health authorities must set priorities in the face of resource constraints. Decision-makers seek practical ways to set priorities fairly in strategic planning, but find limited guidance from the literature. Very little has been reported from the perspective of Board members and senior managers about what criteria, processes and parameters of success they would use to set priorities fairly. Discussion: We facilitated workshops for board members and senior leadership at three health care organizations to assist them in developing a strategy for fair priority setting. Workshop participants identified 8 priority setting criteria, 10 key priority setting process elements, and 6 parameters of success that they would use to set priorities in their organizations. Decision-makers in other organizations can draw lessons from these findings to enhance the fairness of their priority setting decision-making. Summary: Lessons learned in three workshops fill an important gap in the literature about what criteria, processes, and parameters of success Board members and senior managers would use to set priorities fairly. Background Hospitals and regional health authorities in Canada and elsewhere are facing significant resource allocation challenges. Priorities must be set among competing opportunities because demand for health care exceeds available resources. Board members and senior administrators are looking for practical ways to improve how they set priorities under resource constraints. The priority setting literature describes priority setting in various health care contexts [1-9]. It identifies a number of decision-making principles and approaches that could be used to set priorities [10-16]. However, very little has been reported from the perspective of Board members and senior administrators themselves about what decision-making elements (criteria and processes) they would find most useful in setting priorities or how they would evaluate the success of a priority setting exercise. Fairness is a key ethical goal of priority setting when health care resources are scarce. Experience shows that there is often disagreement on what principles should be used to make fair allocation decisions (i.e., distributive Published: 08 September 2004 BMC Health Services Research 2004, 4:25 doi:10.1186/1472-6963-4-25 Received: 11 February 2004 Accepted: 08 September 2004 This article is available from: http://www.biomedcentral.com/1472-6963/4/25 © 2004 Gibson et al; licensee BioMed Central Ltd. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.