Single hospital boards have been the selected method of governance since the first hospitals were built in this country in the 1600s. However, in recent years, governance of the Canadian healthcare system has undergone a radical transformation. Single hospital boards have almost disappeared. Instead, hospitals have been clustered together by governments into multiple-hospital consortia, or into regions, often with other non-hospital healthcare organizations that had previously enjoyed autonomous governance (e.g., boards of public health).

What are the results of these changes? What are the differences in the structures, operations, functions and the outcomes between healthcare boards with the responsibility for governance of a healthcare system, such as the regional health authorities, and those responsible for governance of a single hospital?