Clinical governance

The more I know, the less I sleep: Global perspectives on clinical governance 

The healthcare sector is still exploring how best to provide oversight and assurance, govern, as well as measure and monitor quality and safety. This report examines the emerging leading practices from some global best-in-class providers and thought leaders.

In studying how successful organizations are developing their clinical and corporate governance, it becomes apparent that for a board to be ’in control’ means having a culture devoted to quality, responsibility and accountability of staff, optimized and standardized processes, and systematic, real-time measurement.


Boards, C-suite executives, commissioners and regulators have spent decades developing the processes and activities associated with managing and reducing costs. However this research reveals they have much less experience and available guidance for quantifying, measuring and reporting the quality of patient outcomes in terms of safety, effectiveness, patient satisfaction and timeliness. Where other industries have introduced rigorous controls and reporting requirements, healthcare is still evolving its governance of quality care.


There is a mix of anxiety, curiosity and desire associated with the quest to provide great quality care.

Four building blocks towards a ‘high reliability’ healthcare organization

Executive summary

In a ‘high reliability’ healthcare organization, excellence is planned, outcomes are methodically measured, and safety is an absolute priority.

System governance: assuring quality

Many healthcare leaders perceive a disconnect between the internal drive for excellence and external requests for measurement and assurance.

Clinical and corporate governance: delivering quality reliably

Few if any of the world’s healthcare leaders would claim that their organizations are fully ‘in control’.

Conclusion: the path to progress

Healthcare organizations making progress along the path to high reliability have adopted some or all of the following actions.

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