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The purpose of this paper is to discuss the challenges faced in Australia to maintain and sustain quality in pathology services, and present new strategic directions to address such challenges.

The paper is a review of the literature on pathology services and its quality of delivery and emerging issues.

Major issues are emerging in pathology services which threaten to impact on the quality of future service delivery. These issues include workforce shortages, growth in inappropriate testing, advancing technology, rural and remote region servicing, and a negative image of the sector. New strategic directions are shown to be necessary in terms of workforce planning and addressing the escalation of new technology and innovation. In order to sustain quality of services, a significant change from current practice is recommended, with strong leadership as the change driver.

This paper highlights the potential impact of emerging issues on future pathology‐service quality. Significant implications for service delivery and patient care quality are reviewed.

This paper provides valuable information on current strategic and planning issues impacting on pathology services. It provides new solutions from the perspective of leadership of health and health services.

Positive organizational scholarship in healthcare (POSH) suggests that, to promote widespread improvement within health services, focusing on the good, the excellent, and the brilliant is as important as conventional approaches that focus on the negative, the problems, and the failures. POSH offers different opportunities to learn from and build resilient cultures of safety, innovation, and change. It is not separate from tried and tested approaches to health service improvement – but rather, it approaches this improvement differently. The paper aims to discuss these issues.

POSH, appreciative inquiry (AI) and reflective practice were used to inform an exploratory investigation of what is good, excellent, or brilliant health service management.

The researchers identified new characteristics of good healthcare and what it might take to have brilliant health service management, elucidated and refined POSH, and identified research opportunities that hold potential value for consumers, practitioners, and policymakers.

The secondary data used in this study offered limited contextual information.

This approach is a platform from which to: identify, investigate, and learn about brilliant health service management; and inform theory and practice.

POSH can help to reveal what consumers and practitioners value about health services and how they prefer to engage with these services.

Using POSH, this paper examines what consumers and practitioners value about health services; it also illustrates how brilliance can be theorized into health service management research and practice.