Patient safety is the core promise every healthcare organization makes to its community. In a world of EHR modernization, cloud migrations, and aggressive AI adoption, that promise now depends as much on healthcare IT and governance as it does on bedside care. As AI-driven tools move from pilots to production—supporting triage, diagnostics, documentation, and operational decisions—the uncomfortable truth is that governance has not kept pace with innovation. That gap is now a direct patient safety risk, not just a technology risk.