The conception of this work was the result of the research experiences of the organizers in health institutions involving the themes of quality, patient safety and hospital accreditation. The reading and the study start with Primary Health Care and the importance of this dimension to ensure the guarantee of care to the clientele, in line with the principles of the SUS. The chapters extend to the discussion of quality in the hospital environment, treating the process of hospital accreditation in Brazil, with experiences and practical experiences of professionals and organizations in the achievement of excellence. To achieve quality, the institutions need to go through a process of continuous improvement, because what we have in the Brazilian scenario is still a dynamic based on cost reduction and there is no priority on patient safety. These are barriers that need to be overcome to ensure a culture of quality and safety in health.