Background Clinical governance is seen as pivotal to improving healthcare quality, yet there are few available tools for tracking progress on its implementation. With this in mind, the authors developed a Clinical Governance Development Index (CGDI) designed to track performances between healthcare organisations and over time.

Methods A survey on implementation of government policy on clinical governance was sent to 3402 New Zealand public hospital specialists. Responses to seven survey items were weighted and combined to form the CGDI. Final scores for each of New Zealand's 21 District Health Boards were converted to percentages.

Results The mean CGDI score was 47.3%, with significant differences in performances across the 21 District Health Boards (F(20, 1178)=3.233, p=0.0000). Scores were higher in boards where respondents perceived governing boards and management worked to support clinical leadership.

Conclusion The CGDI offers a simple method for measuring the extent to which a healthcare organisation is working to develop clinical governance. Its use in New Zealand provides a baseline for tracking clinical governance over time. The CGDI could be easily adapted for use in other healthcare systems.