Clinical governance: culture, leadership and power--the key to changing attitudes and behaviours in trusts.

Clinical governance places for legal duty for quality on Trust chief executives. The article deals with how chief executives can overcome the cultural and behavioural obstacles to change which impede the journey to developing effective structures for clinical governance. To establish effective structures for clinical governance, chief executives will need to address these features of organisational life--culture, power and leadership. The article seeks to provide practical ways in which they can do this.

[1]  Phil R. Manning,et al.  Medicine : preserving the passion , 1987 .

[2]  R. Morton.  How should doctors respond to the CMC's judgments on Bristol? , 1998, The Lancet.

[3]  D. Irvine,et al.  The performance of doctors. i: professionalism and self regulation in a changing world , 1997, BMJ.

[4]  M. Hackett.  Are there alternatives to merger? , 1996, Health manpower management.

[5]  C Davies,et al.  Clinical governance and operations management methodologies. , 2000, International journal of health care quality assurance incorporating Leadership in health services.

[6]  Andrew D. Brown.  Transformational Leadership in Tackling Technical Change , 1994 .

[7]  H A Holm,et al.  Quality issues in continuing medical education , 1998, BMJ.

[8]  G. Hofstede,et al.  Measuring organizational cultures: A qualitative and quantitative study across twenty cases. , 1990 .

[9]  Richard Whittington,et al.  Exploring Corporate Strategy , 1988 .

[10]  R Smith,et al.  All changed, changed utterly , 1998, BMJ.

[11]  Larry R. Smeltzer,et al.  An Analysis of Strategies for Announcing Organization-Wide Change , 1991 .

[12]  Leadership and vision in the NHS: how do we create the "vision thing"? , 1996, Health manpower management.

[13]  H. Campbell,et al.  Integrated care pathways , 1998, BMJ.

[14]  Rosabeth Moss Kanter,et al.  When Giants Learn to Dance , 1989 .

[15]  C. Handy.  The age of unreason , 1989 .

[16]  R. Clement.  Culture, leadership, and power: The keys to organizational change , 1994 .

[17]  Jerry I. Porras,et al.  Common Behavior Changes in Successful Organization Development Efforts , 1986 .

[18]  R. Smith,et al.  Professional and practice development plans for primary care teams , 1998, BMJ.

[19]  Peter Orton,et al.  The New NHS: Modern and Dependable? , 1998 .

[20]  Michelle Graves,et al.  Leadership and vision , 1994 .

[21]  Teresa Joyce Covin,et al.  Participant Perceptions of Positive and Negative Influences on Large-Scale Change , 1990 .