This initiative sought to identify unit participation in clinical registries within a large metropolitan health service and to develop approaches to integration of registry reporting within the organisational clinical governance framework to maximise potential quality improvement benefits. The initiative, led by the Medical Services Department at Alfred Health, initially involved identifying health service participation in clinical registries via a range of mechanisms, including one-on-one meetings with clinical registry investigators. In conjunction with the Clinical Governance Unit, tools to summarise and track clinical registry information at Alfred Health over time were developed and piloted. Alfred Health identified 69 clinical registries in which its units participated. These were heterogeneous in terms of clinical area and purpose, as well as the nature and frequency of reporting. Engagement with clinicians led to the establishment of a registry interest group, a calendar of clinical quality registry reports, and a guideline and reporting template and dashboard. Clinician engagement and medical leadership were critical to the development of this initiative. The reporting tool and dashboard have had initial success, with long-term success ultimately being measured by the routine incorporation of registry outcomes into clinical governance reporting over time. What is known about the topic?: Health service clinical governance systems require the collection, analysis and ongoing monitoring of clinical performance and quality improvement information. These data may be from internally derived clinical indicators or from external datasets, such as clinical registries. However, although clinical registries have traditionally provided information at the unit level, mechanisms to systematically incorporate these clinical measures into health service clinical governance systems have been lacking. What does this paper add?: This paper provides a case study of the steps taken by one large health service to identify, engage clinicians and incorporate disease-specific clinical registry indicators into its organisational clinical governance framework. It highlights the complexity of the task through the time taken to identify, translate and summarise key clinical information into a format suitable for organisational committee reporting. What are the implications for practitioners?: This paper highlights to health service managers the importance of initial and ongoing engagement of clinicians in the development of a shared approach to organisational use of clinical registry data. It outlines potential steps that can be taken within a health service to engage clinicians in sharing registry information, and processes that can assist in systematically incorporating registry information into actionable organisational-level reporting as part of clinical governance.