Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 6 1 2017 01 01 Governance Must Dive Into Organizations to Make a Real Difference; Comment on “Governance, Government, and the Search for New Provider Models” 49 51 3236 10.15171/ijhpm.2016.89 EN Jean-Louis Denis Canada Research Chair in Governance and Transformation of Health Organizations and Systems, École nationale d’administration publique, Montréal, QC, Canada Susan Usher Health Innovation Forum, Montréal, QC, Canada Institute for Strategic Analysis and Innovation, McGill University Health Centre, Montréal, QC, Canada École nationale d’administration publique, Montréal, QC, Canada Journal Article 2016 04 23 In their 2016 article, Saltman and Duran provide a thoughtful examination of the governance challenges involved in different care delivery models adopted in primary care and hospitals in two European countries. This commentary examines the limited potential of structural changes to achieve real reform and considers that, unless governance arrangements actually succeed in penetrating organizations, they are unlikely to improve care. It proposes three sets of levers influenced by governance that have potential to influence what happens at the point of care: harnessing the autonomy and expertise of professionals at a collective level to work towards better safety and quality; creating enabling contexts for cross-fertilization of clinical and organizational expertise, notably through teamwork; and patient and public engagement to achieve greater agreement on improvement priorities and overcome provider/manager tensions. Good governance provides guidance at a distance but also goes deep enough to influence clinical habits. https://www.ijhpm.com/article_3236_a418a7240686fa481987e2fc5f47e57f.pdf