Governing boards of healthcare organizations in Canada are accountable for the performance of their organization and provide oversight on their decisions. Traditionally, many healthcare boards have focused on finances and community relations and have deferred responsibility for quality of care to the medical or professional staff. This deferral reflects not only recognition of the expertise of clinical leaders on these issues but also the historical separation of responsibilities between the administration and the medical staff, the former being responsible for financial and operational issues, and the latter for quality of care.