ABSTRACT
This chapter focuses on the internal regulation of safety and quality within hospitals by managers and clinical leaders. The distinctive nature of hospital governance is discussed as hospitals are organizations that present unique management challenges. Internal hospital governance is analysed in relation to three functions: regulating the hospital environment, regulating staff, and regulating procedures. The chapter concentrates on activities that bear upon the safety and quality of patient care. Models of hospital governance, replete with management theories and consultant nostrums, come and go without much systematic evaluation. Hospitals are distinctive organizations in having highly professional employees who are more powerful than employees in other forms of organizations. The ethos of corporate governance is that the buck stops here': the executive body of a hospital is responsible for patient care within the hospital and is responsible for making the appropriate arrangements for ensuring safe and high quality care.
