Background Clinical governance has emerged as a foundational pillar in modern healthcare systems, ensuring accountability, safety, and continuous improvement. In Ayurveda hospitals, variability in documentation and procedural standardization historically limited measurable quality assessment. NABH accreditation introduced structured frameworks for governance, safety, and monitoring.

Objectives To critically examine the structure of clinical governance systems in NABH-accredited Ayurveda hospitals and analyze their impact on patient safety and outcome indicators.

Methods A comprehensive narrative review methodology was employed. NABH AYUSH standards, infection control guidelines, biomedical waste rules, clinical audit frameworks, and patient safety models were analyzed. Governance principles were mapped to structure–process–outcome domains.

Results NABH implementation strengthens clinical standardization, documentation integrity, infection prevention systems, adverse event monitoring, and continuous quality improvement cycles. These collectively enhance patient safety and institutional credibility.

Conclusion NABH accreditation operationalizes clinical governance within Ayurveda institutions, creating measurable, auditable, and sustainable patient safety systems.