26 February 2020

Vancouver – The BC Patient Safety & Quality Council today established a more inclusive and strengthened definition of health care quality that will enable better outcomes and experiences of care for all British Columbians.

The Council, British Columbia’s leader on health care quality, released an updated BC Health Quality Matrix which sets a common language and understanding about how to support people and their communities to thrive. A single, shared definition of quality impacts how those within the health care system set priorities as well as how they care for people. The updates ensure British Columbia’s vision of high-quality care aligns with the latest evidence and honours the history and teachings of Indigenous Peoples in the province.

“We are striving to create a health system that identifies key areas of improvement to make the system better and safer for all,” said Health Minister Adrian Dix. “The work behind the scenes at the BC Patient Safety & Quality Council is integral to a more inclusive and accessible health system and I applaud their progress on developing a Matrix that appropriately defines high-quality care, so we can continue to move forward.”

Updates to the BC Health Quality Matrix emphasize the link between social determinants of health and quality, stress the importance of the early years of life as integral to health and align with the health care system’s focus on promoting wellness. This new definition also embeds Indigenous perspectives on health and wellness and identifies what is possible when Indigenous and non-Indigenous worldviews are welcomed. This inclusion is in alignment with BC’s commitment to fully adopt and implement the United Nations Declaration on the Rights of Indigenous Peoples, and the Calls to Action of the Truth and Reconciliation Commission.

The BC Health Quality Matrix defines quality through the lens of seven dimensions: Respect, Safety, Appropriateness, Accessibility, Effectiveness, Equity and Efficiency. The dimensions span five Areas of Care: Optimizing the Early Years, Strengthening Health and Wellness, Returning to Health and Wellness, Living with Illness or Disability, and Coping with Transition from Life.

“The standard for quality established by the BC Health Quality Matrix will lead to health care that better supports people and communities to thrive,” said Colleen Kennedy, executive director of health system improvement & engagement at the BC Patient Safety & Quality Council. “In particular, together with the First Nations Health Authority, we’ve taken a world-leading approach in ensuring British Columbia’s thinking on quality embraces the history of Indigenous Peoples in BC.”

The BC Patient Safety & Quality Council first published the BC Health Quality Matrix in 2009, after which the definition of quality was adopted by the province’s health authorities, Ministry of Health and key health system stakeholders. The updated Matrix released today is the result of a partnership between the Council and the First Nations Health Authority as well as the collaboration of numerous community members and more than 30 organizations.

Updates to the BC Health Quality Matrix include:

  • The Respect dimension (previously named Acceptability) now clearly honours a person’s choices, needs and values.
  • The Safety dimension now includes fostering security and trust, in addition to avoiding harm.
  • The Equity dimension now recognizes that providing equitable care requires understanding and recognizing differences in people’s histories and experiences.
  • A new Area of Care – Optimizing the Early Years – accounts for the critical role of the early years of life.

Throughout the BC Health Quality Matrix, the concept of health quality has been broadened to include health and wellness, and focus has been placed on the whole person. Additionally, the concept of care as relational has been strengthened, and core values of cultural safety and humility as well as person- and family-centred care have been enhanced.


The BC Patient Safety & Quality Council receives its mandate from the Minister of Health to:

  • Bring system-wide leadership and co-ordination in advancing a culture of quality within the province;
  • Facilitate the building of capability and expertise for patient safety and quality in the BC health system;
  • Support health authorities and other health sector stakeholders in their continuing efforts to improve quality;
  • Improve health-system transparency and accountability to patients and the public for the safety and quality of care provided in BC; and
  • Identify and promote local, regional and provincial opportunities for engaging the patient perspective in health care transformation.


BC Health Quality Matrix

BC Health Quality Matrix Companion Guide

What is Quality?


 The BC Health Quality Matrix supports Indigenous Peoples’ rights to shared decision-making and high-quality care without experiencing interpersonal and systemic bias and racism. The Matrix also considers Indigenous knowledge and practices passed through oral tradition as evidence which can inform care, and core values of cultural safety and humility are embedded throughout. Specific UNDRIP articles advanced by the Matrix include:

  •  Article 2
    Indigenous peoples and individuals are free and equal to all other peoples and individuals and have the right to be free from any kind of discrimination, in the exercise of their rights, in particular that based on their indigenous origin or identity.
  • Article 21
    Indigenous peoples have the right, without discrimination, to the improvement of their economic and social conditions, including, inter alia, in the areas of education, employment, vocational training and retraining, housing, sanitation, health and social security.
  • Article 24
    Indigenous peoples have the right to their traditional medicines and to maintain their health practices, including the conservation of their vital medicinal plants, animals and minerals.
    2. Indigenous individuals have an equal right to the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view to achieving progressively the full realization of this right.

 The BC Health Quality Matrix provides a common language and understanding about quality for all those who engage with, deliver, support, manage and govern health and wellness services. Having a shared definition for BC facilitates a coordinated approach to thinking and learning about the multiple Dimensions of Quality, how the dimensions relate to one another, and responsibilities throughout a person’s health and wellness journey.

It also enables the development of metrics that comprehensively measure quality across the continuum of care and across dimensions. While all the parts of the Matrix are interconnected, considering the different dimensions and areas is a useful way to think about and measure quality.