title: Shifting clinical accountability and the pursuit of quality: aligning clinical and administrative approaches.
abstract: This paper presents a narrative review of the literature on clinical accountability, and draws particularly on England's experience establishing "clinical governance" as a base to examine the establishment of a clinical accountability framework for cancer services in Ontario. The review suggests that clinical governance and accountability approaches that actively mesh clinical and administrative approaches at both system and local levels are more likely to be effective in improving quality of care.
authors.affiliation: Cancer Services and Policy Research Unit, Cancer Care Ontario, Canada.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Dobrow
authors.forename: Terrence
authors.initials: T
authors.lastname: Sullivan
authors.forename: Carol
authors.initials: C
authors.lastname: Sawka
mesh_terms: D002173:Cancer Care Facilities / Q000592:standards; D054976:Clinical Governance; D006801:Humans; D007857:Leadership; D008495:Medical Oncology / Q000592:standards*; D017146:Models, Organizational; D009313:National Health Programs / Q000592:standards*; D009864:Ontario; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D012941:Social Responsibility; D013222:State Medicine / Q000592:standards*; D006113:United Kingdom