Allan D. Spigelman
Surgical Professorial Unit, St Vincent’s Hospital Clinical School,
University of New South Wales, Darlinghurst, Australia, and
St Vincent’s Hospital Clinical School,
University of New South Wales, Darlinghurst, Australia
Purpose – The purpose of this paper is to overview, background and context to clinical governance in
Australia, areas for further development and potential learnings for other jurisdictions.
Design/methodology/approach – Commentary; non-systematic review of clinical governance
literature; review of web sites for national, state and territory health departments, quality and safety
organisations, and clinical colleges in Australia.
Findings – Clinical governance in Australia shows variation across jurisdictions, reflective
of a fragmented health system with responsibility for funding, policy and service provision
being divided between levels of government and across service streams. The mechanisms
in place to protect and engage with consumers thus varies according to where one lives. Information
on quality and safety outcomes also varies; is difficult to find and often does not drill down
to a service level useful for informing consumer treatment decisions. Organisational stability
was identified as a key success factor in realising and maintaining the cultural shift to deliver
Research limitations/implications – Comparison of quality indicators with clinical governance
systems and processes at a hospital level will provide a more detailed understanding of components
most influencing quality outcomes.
Practical implications – The information reported will assist health service providers to improve
information and processes to engage with consumers and build further transparency and accountability.
Originality/value – In this paper the authors have included an in depth profile of the background and
context for the current state of clinical governance in Australia. The authors expect the detail provided
will be of use to the international reader unfamiliar with the nuances of the Australian Healthcare
System. Other studies (e.g. Russell and Dawda, 2013; Phillips et al., n.d.) have been based on deep
professional understanding of clinical governance in appraising and reporting on initaitives and
structures. This review has utilised resources available to an informed consumer seeking to
understand the quality and safety of health services.
Keywords Clinical governance, Performance reporting, Quality and safety, Accreditation,
Quality outcomes, Information and processes
Paper type General Review
The review utilised a non-systematic web-based literature search and interviews with
The literature search was limited to Australian data identified through key search
terms. Search terms included: patient outcomes, quality and safety, patient satisfaction,
patient experience, hospital performance, comparing hospitals, clinical governance,
health standards and health accreditation.
The Department of Health and individual state web sites were accessed and
searched for clinical governance policy and processes, quality and safety, outcome
reporting, key performance indicators and patient satisfaction.
The web sites of the medical and surgical colleges were accessed and searched for
clinical governance policy and quality and safety.
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