Transformational change in health care systems: An organizational model

Background: The Institute of Medicine's 2001 report Crossirig the Quality Chasm argued for fundamental redesign of the U.S health care system. Six years later, many, health care organizations have embraced the report's goals, but few have succeeded in making the substantial transformations needed to achieve those aims. Purposes: This article, offers a-model for moving organizations from short-term, isolated performance improvements to sustained, reliable, organization-wide, evidence-based improvements in patient care. Methodology: Longitudinal comparative case studies were conducted in 12 health care systems using a mixed-methods evaluation design based on semistructued interviews and document review. Participating health care systems included seven systems funded through the Robert wood Johnson Foundation's Pursuing Perfection Program and five systems With long-standing commitments to improvement and high-quality care.