Table of Contents

• Introduction
• Model of Transformational Performance Improvement
• Determining and Communicating a System-level Goal
• Developing and Using System-level Measures of Performance
• Understanding and Managing Interdependencies
• Selecting a Portfolio of Projects Aligned with System-level Goals
• Creating an Engine for Improvement
• Implementing, Spreading, and Sustaining Improvements
• Common Barriers to Successful Performance Improvement
• Future Directions in Research on Performance Improvement in Health Care Organizations
• Conclusion
• Acknowledgments
• References