Service Delivery Organizations Research Articles

Organizational Culture and Hotel-Quality Services Delivery in Enugu Metropolis, Enugu; Nigeria

Organizational culture is the collection of business practices, ethics, processes, and interactions that make up the work environment more favorable and productive. Due to the pivotal role organizational culture plays in the hotel business, managers and hotel owners invest heavily in human and material resources to bridge the communication gap. However, there are still inconsistencies and lacuna between the employer and employees in the hotel industry in Enugu Metropolis which do result in a hostile and unpleasant working environment leading to poor service delivery. This study examined the relationship that exists between organizational culture and hotels quality service delivery in Enugu Metropolis, Enugu State. The study adopted a descriptive survey research design and data were collected from respondents with the aid of a structured questionnaire. Collected data were analyzed using the arithmetic mean. Hypotheses were tested using Pearson Product Moment correlation Coefficient via Statistical Packages for Social Science (SPSS 23). Findings showed that there is a significant relationship between organizational behavior and quality service delivery in hotels in Enugu Metropolis. The study concluded that organizational culture has a great impact on the quality of services hotels in Enugu Metropolis offers to the customer, and recommended that management of hotels in Enugu Metropolis should inculcate the organizational value and international best practices to the functionality of her staff as that will help sell out the organizational image to the satisfaction of their customers which is ultimate in the hotel business.

Care transition for complex patients: a framework to analyse and develop the Operating Centres for Transition

PurposeTransitional care (TC) models emerged to ensure healthcare coordination and continuity, as at-risk patients transfer between different settings or different levels of care within the same setting. TC models have been developed in many countries as well as within different healthcare service delivery models and organizations. This paper aims to focus on a TC model developed in Italy called Operating Centre for Transition (OCT), in order to (1) explore its distinctive features by establishing a framework of analysis, (2) apply the framework to study two OCTs and (3) provide recommendations on how to use the framework to evaluate and develop new OCTs in the future.Design/methodology/approachThe authors adopted a grounded theory method to develop and validate the framework of analysis. The authors employed several qualitative methods following four iterative and recursive steps: (1) desk analysis of relevant documents, (2) in-depth interviews to key informants, (3) three meetings of an expert working group and (4) application of the framework to two case studies.FindingsThe framework of analysis identifies three core dimensions that are always present in any OCT: the service model, the functions and the organizational features. Moreover, for every dimension several variables that capture and understand OCTs’ nature, role and development level are identified.Originality/valueThe results of the study highlight the key elements of the OCT model in Italy and show that the proposed framework can be useful both to analyse existing OCTs and to support health managers and policy makers to create new OCTs or develop those already active.

Exploring Quality in the Applied Behavior Analysis Service Delivery Industry.

As the applied behavior analysis (ABA) service industry (“the industry”) continues to rapidly expand, it faces three major problems. First, ABA service delivery quality (ASDQ) is undefined in ABA research and the industry. Second, we cannot rely exclusively on professional organizations that oversee licensure and certification to control ABA service delivery quality because they do not have control over the relevant contingencies. Third, without objective indicators of ABA service delivery quality, it is difficult for ABA organizations to distinguish the quality of their services from competitors. In this article, first we explain the need for more critical discussion of ASDQ in the field at large, briefly describe a sample of common views of quality in ABA research and the industry, and identify some of their limitations. Then we define ASDQ and present a cohesive theoretical framework which brings ASDQ within the scope of our science so that we might take a more empirical approach to understanding and strengthening ASDQ. Next, we explain how organizations can use culturo-behavioral science to understand their organization’s cultural practices in terms of cultural selection and use the evidence-based practice of ABA at the organizational level to evaluate the extent to which methods targeting change initiatives result in high ASDQ. Lastly, in a call to action we provide ABA service delivery organizations with six steps they can take now to pursue high ASDQ by applying concepts from culturo-behavioral science and total quality management.

Assessing the new Natural Resources Conservation Service water supply forecast model for the American West: A challenging test of explainable, automated, ensemble artificial intelligence

Western US water management is underpinned by spring-summer water supply forecasts (WSFs) from hydrologic models forced primarily by winter mountain snowpack data. The US Department of Agriculture Natural Resources Conservation Service (NRCS) operates the largest such system regionally. NRCS recently developed a next-generation WSF prototype, the multi-model machine-learning metasystem (M4). Here, we test this ensemble artificial intelligence (AI)-based prototype against challenging theoretical and practical criteria for accepting a new operational WSF model. In 20 hindcasting test-cases spanning diverse environments across the western US and Alaska, on average out-of-sample R2 and RPSS improved over 50% and RMSE improved 13% relative to current benchmarks. The M4 ensemble mean forecast also performed more consistently than any of its diverse constituent models and in several cases outperformed all of them. Live operational testing at a subset of sites during the 2020 forecast season additionally demonstrated logistical feasibility of workflows, as well as geophysical explainability of results in terms of known hydrologic processes, belying the black-box reputation of machine learning and enabling relatable forecast storylines for clients. This was accomplished using WSF-focused pragmatic solutions, like “popular votes” for different candidate predictors among the constituent forecast systems, and graphical visualization of reduced-dimension, AI-extracted nonlinear feature-target relationships. We also found that certain M4 technical design elements, including autonomous machine learning (AutoML), hyperparameter pre-calibration, and theory-guided data science, collectively permitted automated (“over-the-loop”) training and operation. Overall, the analyses confirmed M4 meets requirements for NRCS operational adoption. This finding signals that, despite negligible operational-community uptake of machine learning so far, suitably purpose-designed novel AI systems have capacity to transition into large-scale practical applications with service-delivery organizations; it appears M4 will be the largest AI migration into operational river forecasting to date. It may ultimately provide a broader integration platform for harnessing multiple data and model types.

Designing Organization Structure for Effective Service Delivery in Public Ecosystems in Kenya

The public organizations do receive complaint reports from customers which causes disruption of service deliveries affecting economic growth and social life of citizens. The purpose of the study is to determine how designing organization structures supports implementation of strategies, adopted technology and the service delivery in the security and safety industry. The low level of service delivery is not expected from an organization with many layers of structures, departments with division of functions. The study used quantitative approach of descriptive, explanatory method and structural equation modeling to analyze the data. A questionnaire tool was used to collect the data through drop and pick approach. A sample size of 452 respondents was selected through stratified random sampling from the target population. The results are that overlapping, ambiguities, non- sharing of organization chart affects service delivery in organizations. The researchers and practioners will learn that additional layering of structures and positions which are not linked to the core set of values of the business and organization strategy, should be down scoped because they end up creating ‘parked leaders’ with no clear work autonomy thus disrupting the service delivery in an organization. There is no need to appoint officers to positions which were not created through job analysis. Such placements cause disharmony within employee working relationships. The executive should provide smart transitional leadership framework from the old to the new structures to reduce resistance, slowing down ofservice delivery and strategic implementation in thepublic organizations. The study was limited to public sector on designing organization structure.

Development of the Tiers of Service framework to support system and operational planning for children\u2019s healthcare services

BackgroundProviding access to pediatric healthcare services in British Columbia, Canada, presents unique challenges given low population densities spread across large geographic distances combined with a lack of availability of specialist providers in remote areas, leading to quality of care shortcomings and inequalities in care delivery. The study objective was to develop a framework that provides a common language and methodology for defining and planning child and youth healthcare services across the province.MethodsThe framework was developed in two phases. In Phase 1, a literature and jurisdictional review was completed using the following inclusion criteria: (i) description of a framework focusing on organizing service delivery systems (ii) that supports health service planning, (iii) includes specialty or subspecialty services and (iv) has been published since 2008. In Phase 2, a series of meetings with key provincial stakeholders were held to receive feedback on the developed Tiers of Service framework versions that were based on the literature and jurisdictional review and adjusted to the British Columbian health care context. The final version was endorsed by the Child Health BC Steering Committee.ResultsTen medical articles and thirteen jurisdictional papers met the established selection criteria and were included in this study. Most frameworks were developed by the Australian national or state jurisdictions and published in jurisdictional papers (n = 8). Frameworks identified in the medical literature were mainly developed in Canada (n = 3) and the US (n = 3) and focused on maternity, neonatal, critical care and oncology services. Based on feedback received from the expert group, the framework was expanded to include community-based services, prevention and health determinants. The final version of the Tiers of Service framework describes the specific services to be delivered at each tier, which are categorized as Tier 1 (community services) through Tier 6 (sub-specialized services). Two consecutive steps were identified to effectively use the framework for operational and system planning: (i) development of a ‘module’ outlining the responsibilities and requirements to be delivered at each tier; and (ii) assessment of services provided at the health care facility against those described in the module, alignment to a specific tier, identification of gaps at the local, regional and provincial level, and implementation of quality improvement initiatives to effectively address the gaps.ConclusionsThe benefits of the Tiers of Service framework and accompanying modules for health service planning are being increasingly recognized. Planning and coordinating pediatric health services across the province will help to optimize flow and improve access to high-quality services for children living in British Columbia.

Organisational citizenship behaviour and service delivery in urban local governments in Uganda

The quality of service delivery in decentralised local governments (LGs) in Uganda remains largely unsatisfactory, despite central government’s efforts to improve resource allocation and develop supporting legal frameworks. This has been partly linked to the extent to which LG staff exhibit ‘organisational citizenship behaviour’ (OCB). Extant literature has not given adequate attention to OCB in the decentralisation discourse, especially in sub-national governments within developing countries such as Uganda. This paper tackles the issue of OCB among LG employees and its relationship to service delivery by addressing the following questions: (a) what is the level of OCB among LG employees and (b) to what extent do various dimensions of OCB relate to the quality of service delivery in the decentralised LG context?
 The study is a cross-sectional survey of 165 LG staff in central Uganda. Both quantitative and qualitative data were collected. Using content analysis and correlational analysis, the study found that OCB among LG employees is too low, and that higher levels of OCB are associated with improved service delivery. The study recommends that LGs should prioritise effective leadership and supervision, a client-centred performance culture, and empowerment of staff in order to promote OCB among employees and thereby enhance service delivery to local communities.

The organizational trauma-informed practices tool (O-TIPs): Development and preliminary validation.

The goal of the study was to develop and validate a simple, short, easy to self-administer, and cost-effective tool to assess organizational trauma-informed practices (O-TIPs), by building on existing tools. The tool was developed through a series of steps involving detailed examination, selection, and modification of existing trauma-informed (TI) frameworks and tools, which resulted in a 31-item questionnaire with three domains and eight subscales. The O-TIPs was evaluated for known-group construct validity to determine the degree to which it could discriminate between groups of organizations that were higher and lower on the extent to which they were implementing TIPs, by administering it online to staff at seven federally qualified health centers at two-time points. The domains, subscales, and the overall measure showed high internal consistency and discriminated significantly between known groups of centers at baseline and follow-up. In addition, the tool captured change over time in the extent to which the organizations were implementing TIPs. These findings provide preliminary support for the future use of the O-TIPs tool by service-delivery organizations.

Faith-Based Advocacy for Family Planning Works: Evidence From Kenya and Zambia.

<h3>Key Messages</h3> Although it is often assumed that religion has a negative influence on family planning (FP), virtually all faith traditions support the concept of healthy timing and spacing of pregnancy. Given the growing evidence of the importance of religious leaders and faith-based organizations (FBOs) in shaping policy and reaching communities in support of FP, faith leaders play an important role in advocating for FP and increasing its uptake. FBOs are interested in expanding access to FP and increasing service delivery, yet governments, donors, and nongovernmental organizations give low priority to FBOs for financial, training, and commodity support of FP, resulting in a lack of services for underserved populations. Faith leaders become effective FP advocates with governments and donors through advocacy training, internal discussions to develop church positions on FP, technical information on FP, and evidence-based rationales for FP.

Explicating the role of emerging technologies and firm capabilities towards attainment of competitive advantage in health insurance service firms

Competitive advantage of firms has been a dynamic notion evolving with changing business realities. Emerging technologies have entered the gamut of resources which firms need to actively forecast and manage for competitive advantage. This study explored the idea of competitive advantage in the context of health insurance firms and how emerging technologies can augment existing capabilities towards this goal. The critical nature of health insurance as a social necessity and the application of emerging technologies in healthcare justified the need to theoretically establish what competencies were required for health insurance firms for technology driven competitive advantage. A qualitative method using modified Delphi technique in sequential combination to 43 in-depth expert interviews was used to explicate the factors. Data was analyzed using both qualitative and quantitative content and thematic intensity analysis. Organizational people orientation and service delivery capabilities emerged as foundations of a contemporary competitive advantage framework for health insurance firms supported by technical expertise, knowledge management practices and product innovation strategies. Results indicated that management of emerging technologies exerted a gravitational effect on firm competencies to create a contemporary competitive advantage framework. This study enriched the knowledge on competitive advantage by integrating new day technological imperatives with traditional firm competencies.

Patient volume and quality of primary care in Ethiopia: findings from the routine health information system and the 2014 Service Provision Assessment survey

BackgroundSeveral studies have reported inadequate levels of quality of care in the Ethiopian health system. Facility characteristics associated with better quality remain unclear. Understanding associations between patient volumes and quality of care could help organize service delivery and potentially improve patient outcomes.MethodsUsing data from the routine health management information system (HMIS) and the 2014 Ethiopian Service Provision Assessment survey + we assessed associations between daily total outpatient volumes and quality of services. Quality of care at the facility level was estimated as the average of five measures of provider knowledge (clinical vignettes on malaria and tuberculosis) and competence (observations of family planning, antenatal care and sick child care consultations). We used linear regression models adjusted for several facility-level confounders and region fixed effects with log-transformed patient volume fitted as a linear spline. We repeated analyses for the association between volume of antenatal care visits and quality.ResultsOur analysis included 424 facilities including 270 health centers, 45 primary hospitals and 109 general hospitals in Ethiopia. Quality was low across all facilities ranging from only 18 to 56% with a mean score of 38%. Outpatient volume varied from less than one patient per day to 581. We found a small but statistically significant association between volume and quality which appeared non-linear, with an inverted U-shape. Among facilities seeing less than 90.6 outpatients per day, quality increased with greater patient volumes. Among facilities seeing 90.6 or more outpatients per day, quality decreased with greater patient volumes. We found a similar association between volume and quality of antenatal care visits.ConclusionsHealth care utilization and quality must be improved throughout the health system in Ethiopia. Our results are suggestive of a potential U-shape association between volume and quality of primary care services. Understanding the links between volume of patients and quality of care may provide insights for organizing service delivery in Ethiopia and similar contexts.

That's how it should work: the perceptions of a senior management on the value of decentralisation in a service delivery organisation

PurposeDecentralisation in health care has been proposed as a way to make services more responsive to local needs and by that improve patient care. This study analyses how the senior management team conceptualised and implemented a decentralised management model within a large public health care delivery organisation.Design/methodology/approachData from in-depth interviews with a senior management team were used in a directed content analysis. Underlying assumptions and activities in the decentralisation process are presented in the logic model and scrutinised in an a priori logic analysis using relevant scientific literature.FindingsThe study found support in the scientific literature for the underlying assumptions that increased responsibility will empower managers as clinical directors know their local prerequisites best and are able to adapt to patient needs. Top management should function like an air traffic control tower, trust and loyalty improve managerial capacity, increased managerial skills release creativity and engagement and a system perspective will support collaboration and learning.Originality/valueTo the authors’ knowledge this is the first a priori logic analysis of a decentralised management model in a healthcare delivery organisation in primary and community care. It shows that the activities consist with underlying assumptions, supported by evidence, and timely planned give managers decision space and ability to use their delegated authority, not disregarding accountability and fostering necessary organisational and individual capacities to avoid suboptimisation.

A Study to Analyze the Impact of Knowledge Management (KM) practices in IT Service Delivery Industry in India

Information Technology (IT) Industry in India is growing fast. Organizations across the world are outsourcing the IT services to take advantage of cost and time differences. India plays vital role in supporting the outsourcing services by taking advantage of the language skills and skilled workforce. Knowledge Management (KM) is critical for the continuity of the services and success of the organisations in different domains. This paper analysis the impact of Knowledge Management in Information Technology (IT) Service Delivery Industry in India. The study reveals Knowledge Management improves the performance of the Service Delivery organization. Methodical implementation and continuous improvement of Knowledge Management practices would further accelerate and improve the customer experience.

Moving learning online and the COVID-19 pandemic: a university response

PurposeThis article investigates some ongoing issues faced by higher education institutions (HEIs) having to rapidly move their teaching online during the early stages of the coronavirus (COVID-19) pandemic.Design/methodology/approachThe article incorporates a review of academic and policy literature concerning digitalisation and online learning in universities and qualitative interviews with staff involved in online teaching and learning at a university in Scotland.FindingsFor most HEIs and organisations across the globe, the COVID-19 pandemic has accelerated the speed at which digitalisation and digital ways of working have been embedded in organisational life and service delivery including new ways of learning and working. This has led to a recognition of the need for practically focused, effective inclusive digital interventions. A range of initiatives that have been developed or accelerated in response to the pandemic are discussed. These should be explicitly designed and implemented to also reach individuals from disadvantaged backgrounds, including those with low-skill levels or qualifications and older age groups. Effort is also needed by policymakers and HEIs to better understand the challenges and unintended consequences that digital learning and working poses.Research limitations/implicationsMore research is needed into the methods and implications of increased online teaching. The range of interviewees is limited to one main organisation. A wider range of staff, students, HEIs and other types of organisation would add additional insights.Practical implicationsInsights from interviews highlight a number of institutional responses to digitalisation, which were accelerated by the COVID-19 pandemic. These identify learning and reflection points for HEIs moving to enhanced online teaching provision.Originality/valueThis article provides an analysis of the processes, issues and impacts associated with the rapid shift to digitisation in HEIs at a point in time shortly following the onset of the COVID-19 pandemic in 2020. It raises issues around inclusivity of online learning, pedagogy, unintended consequences of digitalisation and privacy, when moving to online teaching that are relevant both during the pandemic and in the longer term.

High-Risk Cases at the Intersection of Domestic/Family Violence and Child Protection: Learning from Practice

Domestic/family violence (DFV) and child protection co-occurrence of risk is common, with related homicides remaining a grave public concern. Recognising and prioritising high-risk cases that pose a lethal risk remains a complex challenge for practitioners across a range of services and legal jurisdictions. There are significant gaps in practice knowledge about how to assess and respond to high-risk cases involving child protection and DFV concerns, while working safely and effectively. This paper reports on qualitative research conducted with practitioners from a range of justice and service delivery organisations in Queensland, Australia. A community of practice, supported by the U.S. based Safe & Together Institute, provided the forum for data to be collected on participants’ reflections and observations. An action research framework was employed to connect practice learning into research data through an iterative cycle of reflection and review. Ethnographic note taking was used to document arising policy and practice issues. Discussions in the CoP were also recorded and transcribed verbatim. Thematic analysis was undertaken combining inductive and deductive techniques. Key findings include: learning from and partnering with women; applying a perpetrator pattern-based approach in high-risk cases; engaging with men as fathers; and improving the role of the judicial system. Practice needs to be informed by centring the victim/survivor perspective, which requires a collaborative approach while maintaining system integrity to hold the perpetrator within system responses to ensure accountability. There are important learnings for developing service sector responses and future research on high-risk cases.

Information support of an independent assessment of the quality of the conditions of service delivery organizations of the social sphere: the experience of the Russian Federation regions

Information support of an independent assessment of the quality of the conditions of service delivery organizations of the social sphere: the experience of the Russian Federation regions

Mitigating the impact of COVID-19 on tuberculosis and HIV services: A cross-sectional survey of 669 health professionals in 64 low and middle-income countries.

ObjectiveThe experiences of frontline healthcare professionals are essential in identifying strategies to mitigate the disruption to healthcare services caused by the COVID-19 pandemic.MethodsWe conducted a cross-sectional study of TB and HIV professionals in low and middle-income countries (LMIC). Between May 12 and August 6, 2020, we collected qualitative and quantitative data using an online survey in 11 languages. We used descriptive statistics and thematic analysis to analyse responses.Findings669 respondents from 64 countries completed the survey. Over 40% stated that it was either impossible or much harder for TB and HIV patients to reach healthcare facilities since COVID-19. The most common barriers reported to affect patients were: fear of getting infected with SARS-CoV-2, transport disruptions and movement restrictions. 37% and 28% of responses about TB and HIV stated that healthcare provider access to facilities was also severely impacted. Strategies to address reduced transport needs and costs–including proactive coordination between the health and transport sector and cards that facilitate lower cost or easier travel—were presented in qualitative responses. Access to non-medical support for patients, such as food supplementation or counselling, was severely disrupted according to 36% and 31% of HIV and TB respondents respectively; qualitative data suggested that the need for such services was exacerbated.ConclusionPatients and healthcare providers across numerous LMIC faced substantial challenges in accessing healthcare facilities, and non-medical support for patients was particularly impacted. Synthesising recommendations of frontline professionals should be prioritised for informing policymakers and healthcare service delivery organisations.

Organizational Structure and the Performance of State Corporations in Kenya

In the recent past, many state corporations in Kenya have been facing dismal performance trends, a situation that has derailed the sustainability of most of these crucial institutions. While some state corporations have been known to consistently perform well, others have been noted to perennially underperform, over rely on the exchequer, and lose viability in equal measure. Organizational structure is an essential element of any organization. Numerous studies conducted by scholars illustrate that, it is one of the most significant organizational elements in facilitating and increasing innovation, service delivery and performance in organizations. The role of organizational structure however has not been adequately addressed as far as performance of the state corporations is concerned and this study therefore sought to fill the existing gaps by assessing the relationship between organization structure and the performance of state corporations. The study purposed to establish the influence of organizational structure on the performance of state corporations in Kenya. The study reviewed organizational structure as the independent variable and performance of the state corporations as the dependent variable. The study performed a theoretical review of Contingency theory and the New Public Management (NPM) theory. This was followed by an empirical review in tandem with the purpose of this study. It provided a review of scholarly works done in the past identifying the studies, authors, areas of investigation and the findings reported. The study adopted a descriptive research design with an exploratory approach to collect data from 189 state corporations in Kenya. The unit of analysis was all the state corporations in Kenya while the unit of observation was the Heads of Human Resources in each corporation. The study used a sample of 96 state corporations and collected primary data using a self-administered questionnaire. Documentary review was also used to compliment the data collected. To get the most efficient representation of the population the study adopted stratified sampling and Cochran’s (1977) formula was applied to calculate the sample size of 95 Heads of Human Resources departments. The data was analysed using descriptive and inferential statistics. SPSS Version 26 was used. The study concluded that organizational structure had a significant and positive influence on the performance of state corporations in Kenya and recommended that most state corporations should consider leveraging and optimizing key aspects of organizational structure such as concentration of authority degree of bureaucracy and the span of management ratio.

The Effects of Organisational Culture on Service Delivery in Public Institutions in Namibia

This study examined the effects of organisational culture on service delivery at public institutions in Namibia. The organisational culture assessment instrument (OCAI) was used to identify the organisational culture type. The study found hierarchy culture to be the dominant culture type. Further, a customer satisfaction survey based on the SERVQUAL metrics was used to measure the client's perception of the reliability, assurance, empathy, tangibles, and responsiveness of the chosen public institution. In total, 106 staff and clients participated in this study. Most of the clients felt that the chosen institution's empathy and assurance in service delivery were unsatisfactory suggesting that the institution's employees neither display a caring attitude nor politeness when dealing with the clients. The study concluded that lack of assurance and empathy from this hierarchical public institution culture type is the possible cause of poor service delivery among public institutions in Namibia since the study found strong relationship between organisational culture and service delivery.

Clinical governance in New Zealand: perceptions from registered health professionals in health care delivery compared with social insurance.

Objective Effective clinical governance can improve delivery of health outcomes. This exploratory study compared perceptions of clinical governance development held by registered health professionals employed by two different but interrelated health organisations in the broader New Zealand (NZ) health system. Most staff in public sector healthcare service delivery organisations (i.e. District Health Boards (DHBs)) are registered health professionals, whereas these clinical staff represent a small minority (5%) in social insurance organisations (i.e. the Accident Compensation Corporation (ACC)). Given these different contexts, comparison of results from three surveys of clinical governance perceptions identified key learnings for the development of clinical governance. Methods The Clinical Governance Development Index (CGDI) was administered to registered health professional staff in NZ DHBs and ACC, at different time points. The data were explored, compared and reported. Results Responses to survey items completed by NZ DHB staff and registered health professionals employed by ACC were compared. For each administration, there was a similar profile of positive responses across the seven CGDI items. The 2020 ACC survey results for one item were clearly different. This item asked about perceptions of full and active involvement in organisational processes and decision making (i.e. clinical engagement). Conclusions Perceptions of registered health professionals working in the NZ public sector delivering health services were compared with those held by staff employed by a NZ social insurer predominantly commissioning and influencing care. The results indicated similar levels of clinical governance development. Clinical governance development in the ACC context can benefit from clear communication, building strong supporting structures and greater management-clinical provider partnerships. Clinical governance development drives health outcomes and regular measurement of developmental progress can provide momentum. There is room across the NZ health system to raise awareness and leverage clinical governance to deliver improved health outcomes. What is known about the topic? Little is known about the perceptions held by registered health professionals employed by social insurance organisations. There are no published comparative studies exploring differences in perceptions between registered health professionals across two different organisational contexts, both with a goal of improving health outcomes. What does this paper add? Effective clinical governance drives coordinated, quality systems that promote optimal health outcomes. Social insurance organisations predominantly commission healthcare providers to deliver health outcomes. Although registered health professionals employed by social insurance organisations represent a small total number of staff, their perspective on clinical governance, as reported via survey, indicated there is most to be gained in the development of partnerships between management and clinical providers. This exploratory study fills a gap in the existing clinical governance development literature and evidence base. What are the implications for practitioners? Any health organisation can leverage clinical governance to deliver improved health outcomes. Effective clinical governance interventions are targeted to specific organisational context and culture. For ACC, a clear definition, enhanced management-clinical provider partnerships and strong supporting structures or organisational arrangements can be further developed. The survey results indicated that a focus on management-clinical provider partnerships is a clear priority for ACC clinical governance development. Partnerships based in empowered collaboration require greater clinical engagement, as well as increased capability for aligning with organisational priorities. Effective clinical governance development requires attention to context and culture. It can improve delivery of health outcomes.