Journal of Business Ethics

, Volume 117, Issue 3, pp 667-678

First online:

Clinical Governance, Performance Appraisal and Interactional and Procedural Fairness at a New Zealand Public Hospital

  • Carol ClarkeAffiliated withUniversity of Waikato
  • , Mark HarcourtAffiliated withDepartment of Strategy & Human Resource Management, Waikato Management School, University of Waikato Email author 
  • , Matthew FlynnAffiliated withDepartment of Human Resource Management, Middlesex Business School, Middlesex University

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This paper explores the conduct of performance appraisals of nurses in a New Zealand hospital, and how fairness is perceived in such appraisals. In the health sector, performance appraisals of medical staff play a key role in implementing clinical governance, which, in turn, is critical to containing health care costs and ensuring quality patient care. Effective appraisals depend on employees perceiving their own appraisals to be fair both in terms of procedure and interaction with their respective appraiser. We examine qualitative data from interviews and focus groups, involving 22 nurses in a single department, to determine whether perceived injustices impact on the effective implementation of the appraisal system. Our results suggest that particular issues had been causing some sense of injustice, and most of these were procedural. Potential solutions focus on greater formalisation of the performance appraisal process, and more training for appraisers and appraisees.


Clinical governance Performance appraisal Interactional justice Procedural justice