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Health institutions have the most complex organization and management among  all institutions. Unlike traditional management in organizational systems  characterized by analytical and interdisciplinary approach, health  institution management is characterized by trans-disciplinary approach to  solving business problems. Introduction of quality improvement is a challenge  for health care managers due to their responsibility to create an environment  that will lead to quality improvement and safety of health services. New  Health care Act (2005) has created a legal framework for defining quality  indicators, and setting up various committees and bodies in order to improve  the quality of health care. As the planning, management and quality control  are the most important parameters of the health system development, health  manager must be a leader with exceptional communication skills and able to  apply his knowledge and skills in the management of resources. Top managers,  central type and lower level managers must be the driving force of their  institutions creating the basis for activities related to quality. They  should have a proper education as well. New concept of management emphasizes  people and their specialized knowledge. Past practice in Serbia did not show  significant improvements in the management process through the knowledge and  skills of managers, especially in terms of strategic decision-making in the  operation and development of the health system.

The role of managers in improving the health care system in Serbia