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Information technology infrastructure in contemporary large-sized service organisations is growing exponentially in terms of purpose, kind, scope, and complexity. As a result, these organisations are adopting a variety of information technology governance practices to achieve sustained levels of service to meet organisational goals and objectives. This chapter presents a case study of information technology governance in a hospital. It shows that information technology governance practices need to be institutionalised in the social, cultural, technical, and structural environment to produce the desired organisational behavior of responsibility and accountability. It highlights the key success factors that have led to successful assimilation of these practices with business processes, job functions, and workflows in the case organization. This study, thus, expands the theoretical and practical views on implementation of information technology governance.

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Effective management and governance is key to the business and information technology alignment. Just as business organisations have to be responsive to the changes in their operating environment to remain competitive, they also have to be proactive in leveraging technological resources to sense these changes and take appropriate strategic and operational decisions. Governance of information technologies is not the job of technology administrators; in fact, it is everybody's responsibility. With this recognition and understanding, technology stakeholders are able to assume responsibilities and accountabilities to execute and achieve desirable behaviour in the use of information technologies. This paper presents a case study of a bank in Thailand on how it has embedded governance practices in its social, operational, structural, and technical environment. It concludes that maximization of value from information technologies is dependent upon the technical, cultural, and organisational endorsement of business practices relating to their governance.