In the Strategic Directions for the Ontario Hospital Association 2004-2007, one of the four strategic priorities is to "lead excellence in health care governance and promote a culture of shared accountability."1 As a result, the Ontario Hospital Association (OHA), with the support of the Ministry of Health and Long-Term Care (MOHLTC), commissioned this discussion paper as a starting point for a process of governance renewal in the Ontario hospital sector. [To view this article, please download the PDF.]