Purpose – Introducing change is a difficult issue facing all health care systems. The use of various clinical governance levers can facilitate change in health care systems. The purpose of this paper is to define clinical governance levers, and to illustrate their use in a large-scale...

Purpose – The aim of this paper is to illustrate and discuss how healthcare organisations can act as institutional entrepreneurs in a context of change. Design/methodology/approach – The authors conducted an in-depth longitudinal case study (2005-2008) of a healthcare organisation in the...