A more accountable, effective and efficient healthcare system requires the active collaboration of all the professionals involved in a vision and operational approach that privileges the centrality of the patient. Clinical governance, as a framework, but especially in its implementation, should be understood as a continuous process that directs the change of the system towards conditions that effectively realise the possibility of excellence in patient care and service.
The case highlights how some of the clinical governance policies and initiatives are now well established in the community of reference; others, on the other hand, have been added recently but are already contributing to change its culture and operations. The enlarged composition of the Board of Management, initiatives such as those of the Quality and Safety Day and the development of a network of corporate quality and clinical risk referents are among the most effective practices that are increasing how clinicians are involved in the management of the local health authority, achieving the necessary integration between clinical, managerial and leadership aspects.