In all modern healthcare systems, it is difficult for hospitals to keep pace with the increasing number of clinical guidelines. In the Netherlands, this poses a specific problem, as the national quality regulator holds hospital boards responsible for compliance with guidelines. We sought to address this problem by constructing a centralized database of guidelines. Due to the enormous number and the inter-relatedness of the guidelines, this task was larger and more complex than anticipated. This raises questions regarding the feasibility of adhering to external demands and concerning effective management by hospital executive boards of compliance with clinical guidelines.