Quality improvement in New Zealand healthcare. Part 7: clinical governance--an attempt to bring quality into reality.

In this seventh and final article in the Series on quality improvement, we discuss clinical governance and its place in the New Zealand health sector. We describe it as requiring clinicians to accept transparent accountability, teamwork rather than individualism, a systems view and the need to share power with others in the clinical domain. In return, they must be given the autonomy to do the job they are trained for and the resources necessary for that job. Without this quid pro quo, clinical governance will not become a framework for clinicians to work effectively in healthcare organisations. However, with this recognition, it provides a sound basis for clinicians and managers to work together in contemporary healthcare organisations.