From Principles to Practice: An Actionable Framework for AI Governance in Healthcare Organisations

New AI technologies are being rapidly adopted by healthcare professionals, yet existing organisational governance often lacks the processes necessary to oversee their safe and responsible use. Previous AI governance frameworks have focused on high-level AI ethics principles, leaving healthcare organisations struggling to translate them into practice, assess risk, and embed AI oversight into existing processes. We developed a practice-oriented AI governance framework that unifies ethics and governance principles, delivers tiered oversight aligned with digital maturity, and incorporates a structured review checklist for assessing AI tools. Our multimethod approach drew on a scoping review, document analysis, and semi-structured interviews. The resulting framework was validated through stakeholder workshops and applied to exemplar AI tools, demonstrating the checklist’s usability, relevance, and capacity to identify risks and guide decision-making. The framework offers an actionable approach linking principles to operational governance, enabling proportionate oversight, integration with existing processes, and ongoing monitoring, addressing a gap in a field where guidance remains largely conceptual.