The purpose of this study is to analyze the change of hospitals that patients safety and quality improvement by accreditation process and to examine the impact or interrelation of leadership, organizational culture, hospital management activities and recognition of hospital management performances. The data were collected through a review of the literature, and selfadministered survey with a structured questionnaires to 714 subjects from several medical staff members, administration staff members, nursing staff members, medical technicians and other staff members working in 23 accredited hospitals in Korea. In this analysis hierarchical multiple regression and structural equation model were used. The conclusion of this study provides a theoretical model for understanding organizational changes brought about by accreditation system. Factor on improvement of efficiency and raise the morale, rather than increase of medical income and reduce of the cost factors, had a stronger influence on the accreditation process. In the future, the hospital`s participation to induce the accreditation program voluntarily will come up with an alternative policy concern about financial perspective. Also, the hospitals which preparing accreditation program to achieve the goal efficiently, will make use of transformational leadership through enhancing individual consideration and intellectual development to leading members participation. Additionally, non-accredited hospitals should aim at professional culture by innovative and creative approaches, and inviting members to learning and growth in the organization.