Being strategic guidance, International Standardisation Organisation (ISO) certification and hospital accreditation offer alternative mechanisms as management and improvement tools for quality and safety, or as a mark of an accomplishment. Instruments for the external assessment of hospitals and their analyzed internal quality control are useful for the development of health care and function as mechanisms to give public trust in the quality level of the organizations that comprise national health services. Both facilitate measures to improve patient safety and strengthen quality culture including safety aspects. Several health organizations testify to their support processes according to ISO 9001, such as managing medical devices and engineering systems.