[This paper is a commentary on Operational Review: The London Health Sciences Centre Experience by Tony Dagnone and Barbara Willis.]

The senior management of the LHSC are to be congratulated for presenting their experience with an operational review. Operational reviews have become an important tool for resolving major financial issues between the Ontario Ministry of Health and Long Term Care (MOHLTC) and individual hospitals. These reviews have two aspects: Is the hospital doing the "right work" clinically? and Given its unique circumstances, is it doing the "work" at the appropriate "cost"? The need for these reviews has arisen for two reasons. First, the recent profound restructuring of hospital care has occurred without the appropriate financial and clinical analyses. Second, there have been no base-line reviews of Ontario hospitals in decades.