Developing clinical governance in a service for people with intellectual disabilities

Joanne Kelleher (Health Policy and Management, Trinity College, University of Dublin, Dublin, Ireland)
Eilish McAuliffe (Centre for Global Health and School of Medicine, Trinity College, University of Dublin, Dublin, Ireland)

Clinical Governance: An International Journal

ISSN: 1477-7274

Publication date: 12 October 2012



Clinical governance has become internationally recognised as a whole‐system framework for the continuous improvement of quality in health service delivery. This study aims to explore the issues in implementing a comprehensive clinical governance framework in an organisation that provides services to children and adults with intellectual disabilities supported by a wide range of clinical interventions and therapies.


This was an action research study that utilised a co‐operative inquiry approach because of its capacity to facilitate engagement in a collaborative “bottom‐up” meets “top‐down” process amalgamating theory with organisational priorities to achieve practical and planned change. Action research methodologies use a problem solving approach, focus on real‐life issues, and are open and inclusive. The study aimed to identify current practices in inter‐disciplinary team working including the measurement and monitoring of quality, and to design collaboratively an integrated team‐based service delivery model that focuses on continuous improvement in the quality of clinical services.


The study highlights the benefit of adopting a co‐operative inquiry approach to the development of a clinical governance framework. Staff at all levels began to take ownership of the clinical governance agenda. The systemic perspective promoted collaboration across clinical and non‐clinical disciplines and it is anticipated that it will result in new approaches to service quality in the organisation in the future.


This case study demonstrates how the practical and participatory approach of the action research and co‐operative inquiry methodologies can contribute to the resolution of a real organisational issue and enable transformational change in the infrastructure of clinical services.



Kelleher, J. and McAuliffe, E. (2012), "Developing clinical governance in a service for people with intellectual disabilities", Clinical Governance: An International Journal, Vol. 17 No. 4, pp. 287-296.

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Copyright © 2012, Emerald Group Publishing Limited

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