This study assessed the influence of quality improvement practices on creative governance success in Tier four public hospitals in Kenya. The study adopted a descriptive correlation research design. The target population was 200 composed of Administrative officers and Mid-level employees from each hospital. A census survey of 200 respondents was used. A Questionnaire yielding an acceptable reliability coefficient 0.7 and response rate of 157 respondents was attained during data collection. The background information was analyzed using descriptive statistics such as frequencies and percentages. The hypothesis testing was done using linear regression analysis. Quality Improvement (QI) practices assessed entailed: Establishment of dedicated quality improvement teams, holding of regular quality improvement meetings, establishing QI procedures/models, evidence of QI data collection and analysis and, monitoring to measure change. Overall, there is implementation of QI practices to some extent in the Tier four hospitals in Kenya. Correlation analysis between QI practices and creative governance indicated a strong positive significant relationship (r= 0.672 p= 0.00,). Creative governance was measured by innovative ideas/products, creative designs of processes, learning new skills, attainment of organization goals, motivated staff and satisfied clients. On testing the study hypothesis, results showed that quality improvement practices influenced creative governance (β= 0.55; p=0.000) but to mere 55% in the case of these selected public hospitals. The study results therefore inform hospital managers on the need to pay more attention to quality improvement practices so that the hospitals may reap the benefits of creative governance which then leads to superior delivery of services.