Clinical governance—from rhetoric to reality?

Clinical governance and the learning organization

“…While each aspect of CG is important, to date some have received more attention and are more fully implemented than others (Lugon 2002). In outlining the features no priority ordering is implied.…”

“…CG demands that goals of the individual, the team and the organization are aligned (Lugon 2002). The need to think beyond the individual contribution of a clinician is necessary not only for the improvement of systems and processes within the NHS, but also because the provision of safe, high‐quality services for patients requires it (Nicholls et al.…”

“…This highlights the problems associated with trying to achieve culture change through the policy process. While implementation at Trust level allows for adaptation to reflect local needs and priorities, the goal of overall quality improvement is still some way off, with considerable variation between different institutions (Lugon 2002).…”

Using clinical governance levers to support change in a cancer care reform

“…Clinical governance levers can be used both by actors in positions of authority (De Bruijn and Ten Heuvelhof, 1997;Denis et al, 2006;Salamon, 2002;Schneider and Ingram, 1990) and by actors involved directly in delivering patient care. In this perspective, clinical governance levers are both top-down and bottom-up (Lugon, 2006). Clinical governance levers encompass a series of processes that connect clinical practice more explicitly to the organizational context in order to achieve the excellence and efficiency promoted by clinical governance.…”

“…The reform of Ontario's cancer system was piloted by CCO, made up of actors in a position of authority. As such, the clinical governance consisted primarily of top-down initiatives (Lugon, 2006;Braithwaite and Travaglia, 2008). As previously…”