The Pillars of Good Goverance

The Institute of Internal Auditors defines governance as “the combination of processes and structure implemented by the board in order to inform, direct, manage, and monitor the activities of the organization toward the achievement of its objectives.” Because of the complex nature of healthcare environments, governance is stratified into four entities:


Organizational Governance

  • The board of directors delegates operational power to executives

  • Functional division of operations into a subset of governing directors


Physician Governance

  • Medical staff organized into committees that provide oversight and endorsement to all aspects of patient care

  • Ad hoc membership in special projects


Clinical Governance

  • Departments/cost centers that are governed by the scope of practice and regulatory/licensure mandates


Project Governance

  • Directed powers to manage specific projects/programs

  • Projects are limited by time, resources, and scope