Professor Cathy Balding

Director, Qualityworks PL;  Australasian Institute for Clinical Governance Facilitator

Learning from Healthcare to Avoid Four Deep Clinical Governance Rabbit Holes  –  It’s Up To Us!

Friday 14 October 2022

11:00am – 11:30am

Speaker Bio

Cathy works with aged, health and  community care boards, executives and leaders to ‘make quality make sense’. She specialises in ‘strategic clinical governance systems with purpose’ that focus on achieving a high quality point of care experience.  After a career as a health service executive, accreditation assessor and quality policymaker, Cathy decided it was time to get to the bottom of what it really takes to implement quality and clinical governance systems for consistently good care. She is the author of three books on this topic and has conducted published research into characteristics of effective quality and clinical governance systems.  Cathy is a current aged care board member and sits on the Department of Health and Aged Care Sector Quality Reference Group.

Her goal is simple: to make it easier for human services to deliver care they are proud of – and to enjoy the process!



Aged care is well positioned to accelerate the speed and effectiveness of clinical governance implementation. The Government mandate for change and guidance from the Royal Commission recommendations has set the sector on the road to more rigorous governance of care quality.  However, even this seemingly solid ground is full of rabbit holes into which provider organisations can disappear.  These traps can significantly reduce return on investment in the effort, time and resources providers are making towards consistently high quality care.

Healthcare has been working with clinical governance for over two decades, since the first large study of adverse events in Australia found the 16% patients were experiencing harm1.  Many probes and public inquiries followed and clinical governance systems were developed and implemented in response. In that time the sector has disappeared down multiple wide and deep  rabbit holes on the path to effective clinical governance – some of which have stalled progress for months and even years.  These setbacks discourage staff and greatly reduce the impact of clinical governance processes on point of care quality.

The aged care sector has an advantage that healthcare didn’t – the opportunity to benefit from healthcare’s hard lessons learned. Any large-scale human service sector implementation will experience mistakes and setbacks,  and it’s inevitable that we’ll learn from making our own mistakes in aged care. However, if we as a sector commit to identifying and avoiding known traps on the path to effective clinical governance, there is potential to leapfrog the healthcare sector and accelerate our clinical governance implementation progress and effectiveness beyond where healthcare is today.

Clinical governance rabbit holes lurk everywhere in national, jurisdictional and industry-level implementation. This presentation presents four of these common traps at provider level:

  1. Activity without purpose
  2. Putting process before people
  3. Tolerating passivity
  4. Confusing fads with foundations.

Boards and executives have the power to avoid these in their own organisations.  Drawing on deep experience and the relevant literature, lessons learned from healthcare will be presented as ‘bridges’  that boards and executives can build to traverse each crevasse and accelerate clinical governance implementation and impact.  After all –  it’s up to us! 

1. Wilson RM et al. The Quality in Australian Health Care Study. Med J Aust. 1995;163(9):458-71.

Big opportunity for aged care to learn from healthcare’s CG implementation: avoiding traps and accelerating progress. Presents four CG rabbit holes for boards and executives to avoid-and how.