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Communication and leadership in healthcare quality governance: Findings from comparative case studies of eight public hospitals in Australia

Alison Brown (School of Business, University of New South Wales, Canberra, Australian Capital Territory, Australia)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 14 February 2020

Issue publication date: 2 April 2020




The importance of hospital board engagement in the work of governing healthcare quality has been demonstrated in the literature. Research into influences on effective corporate governance has traditionally focused on board architecture. Emerging research is bringing to light the importance of governance dynamics. This paper contributes to emerging research through highlighting how communication and leadership underpin effective engagement in governing healthcare quality.


A comparative case study of eight Australian public hospitals was undertaken involving document review, interviews and observations. Case studies were allocated into high- or low-engagement categories based on evidence of governance processes being undertaken, in order to compare and contrast influencing factors. Thematic analysis was undertaken to explore how communication and leadership influence healthcare governance.


Several key components of communication and leadership are shown to influence healthcare quality governance. Clear logical narratives in reporting, open communication, effective questioning and challenge from board members are important elements of communication found to influence engagement. Leadership that has a focus on healthcare excellence and quality improvement are aligned and promote effective meeting processes is also found to foster governance engagement. Effective engagement in these communication and leadership processes facilitate valuable reflexivity at the governance level.

Practical implications

The findings highlight the way in which boards and senior managers can strengthen governance effectiveness through attention to key aspects of communication and leadership.


The case study approach allows the exploration of communication and leadership in greater depth than previously undertaken at the corporate governance level in the healthcare setting.



The author would like to acknowledge the valuable guidance of Professor Helen Dickinson and Professor Margaret Kelaher in providing doctoral supervision. The research was supported by an Australian Postgraduate Award scholarship.


Brown, A. (2020), "Communication and leadership in healthcare quality governance: Findings from comparative case studies of eight public hospitals in Australia", Journal of Health Organization and Management, Vol. 34 No. 2, pp. 144-161.



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