Dr Cathy Balding
Board Facilitator, Australasian Institute of Clinical Governance


Cathy works with human service boards, executives and leaders to make quality make sense – specialising in ‘clinical governance systems with purpose’.

After a career as a quality manager, health service executive, accreditation assessor and policymaker, Cathy has spent the last 20 years as Director of ‘Qualityworks’, focused on creating great point of care experiences with consumers and staff.

She has conducted research into clinical governance effectiveness and is the author of three books on the topic; as well as developing state-wide quality governance frameworks for health and human services.

Cathy is an Adjunct Professor at La Trobe and James Cook Universities, and a Board Director with RSL LifeCare NSW, chairing their Board Quality committee. She works with the Institute of Clinical Governance as a board facilitator, and is one half of ‘the two Cathys’ who host the No Harm Done podcast.





‘Everyday Clinical Leadership’: a missing piece of the aged care clinical governance puzzle.

The pursuit of consistently high quality aged care is a considerable challenge. Key drivers are clinical governance systems that support accountability for quality clinical care, such as standards, measurement, risk management and training. But despite much work in the name of aged care clinical governance over the past few years, key care quality issues remain. Part of the problem is that clinical governance systems lose their potency and become ‘just more work’ unless they are operationalised as enablers for staff to play leadership roles in creating quality clinical care.

What is leadership for quality clinical care? It often manifests as senior, strategic and aspirational, and these are obviously critical characteristics. Equally important, but often missing, is the tactical leadership of creating quality clinical care as part of everyday work. Whether we know it or not, managers and staff lead towards or away from quality care in their daily decisions and actions. If staff don’t know or don’t play their role in creating quality care, clinical governance systems alone cannot bridge this gap.

This paper presents an evidence-based model for positioning staff at all levels as leaders for quality care; exploring three conditions required for ‘everyday clinical leadership’ to make a positive, point of care difference:
1. staff at all levels understand the goals for quality clinical care, in a way that creates meaning and makes sense for them
2. staff are clear about their specific role in achieving the goals and feel supported to enact it
3. staff are encouraged to provide leadership towards the quality clinical care goals – as defined – in their everyday work, and this is linked to creating greater job satisfaction.

These conditions allow staff at all levels to identify and enact their leadership roles towards strategic goals for care greatness. This ‘everyday leadership’ can be built into position descriptions, trained for, supported through line management and enabled with clinical governance systems that are operationalised to be useful. With absolute clarity on what quality clinical care is, and encouragement to play their role in creating it, staff can lead their peers, managers can lead their staff, senior managers can lead their middle managers and boards can lead their organisations towards a common quality care ‘flag on the hill’. Clinical governance systems then come into their own, providing the enabling support for clinical leadership towards achieving quality goals and experiences for both consumers and staff.