title: Healthcare professionals' perceptions of clinical governance implementation: a qualitative New Zealand study of 3205 open-ended survey comments.
abstract: OBJECTIVE
  To investigate healthcare professional perceptions of local implementation of a national clinical governance policy in New Zealand.
  
  
  METHODS
  Respondent comments written at the end of a national healthcare professional survey designed to assess implementation of core components of the clinical governance policy.
  
  
  METHODS
  The written comments were provided by respondents to a survey distributed to over 41 000 registered healthcare professionals employed in 19 of New Zealand's government-funded District Health Boards. Comments were analysed and categorised within emerging themes.
  
  
  RESULTS
  3205 written comments were received. Five key themes illustrating barriers to clinical governance implementation were found, representing problems with: developing management-clinical relations; clinicians stepping up into clinical governance and leadership activities; interprofessional relations; training needs for governance and leadership; and having insufficient time to get involved.
  
  
  CONCLUSIONS
  Despite a national policy on clinical governance which New Zealand's government launched in 2009, this study found that considerable effort is required to build clinical governance at the local level. This finding parallels with other studies in the field. Two areas demand attention: building systems for organisational governance and leadership; and building professional governance arrangements.
authors.affiliation: Department of Preventive and Social Medicine, Centre for Health Systems, University of Otago, Dunedin, New Zealand.
authors.forename: Robin
authors.initials: R
authors.lastname: Gauld
authors.affiliation: Department of Preventive and Social Medicine, Centre for Health Systems, University of Otago, Dunedin, New Zealand.
authors.forename: Simon
authors.initials: S
authors.lastname: Horsburgh
mesh_terms: D001291:Attitude of Health Personnel; D054976:Clinical Governance / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000592:standards*; D006291:Health Policy; D006302:Health Services Research; D006779:Hospitals, Public; D006801:Humans; D007857:Leadership; D009520:New Zealand; D036301:Qualitative Research
keywords: QUALITATIVE RESEARCH