Working in the midst of the transformation of health care is akin to being an elite athlete constantly adjusting to game situations. Or like being a jazz musician playing standards amongst a background of improvisation. We're all trying to carry on with the game plan or musical interpretation — take your pick — as change swirls around us.

We cannot predict all the changes that will be required because of delivery system transformation. We cannot predict how hospital and health system leaders and front-line staff will need to respond. But just as the best athletes need to keep practicing their skills and the best musicians need to keep practicing their techniques, we health care professionals need to keep focusing on performance improvement — working to improve quality and safety, increasing efficiency, and increasing patient and employee satisfaction.

Hospitals in Pursuit of Excellence was established as the American Hospital Association's strategic platform to accelerate performance improvement and delivery system transformation in hospitals and health systems. This past year, HPOE published new guides and reports on cultural competency, health equity, health and wellness and financing strategies. Altogether, HPOE guides have been downloaded more than 50,000 times. The HPOE website ( now includes more than 800 case studies covering such topics as care coordination, medication management, and new payment and care delivery models. The Patient Safety Leadership Fellowship, co-sponsored by the AHA and the National Patient Safety Foundation, has provided an opportunity for nearly 300 health care professionals to pilot evidence-based improvements and build a comprehensive approach to improving safety and developing a culture of safety in their own organizations.

AHA affiliates have partnered on several HPOE initiatives during this past year. The American Organization of Nurse Executives, the American Society for Healthcare Risk Management and Health Forum co-sponsor the AHA-NPSF Patient Safety Leadership Fellowship. AHA Solutions collaborated with Kaufman, Hall & Associates to publish A Guide to Financing Strategies for Hospitals — With Special Consideration for Smaller Hospitals. The Center for Healthcare Governance's new AHA Great Boards website ( provides resources to assist boards of trustees as stewards for transformation. And the new AHA Physician Leadership Forum ( brings together physicians and hospitals to advance excellence in patient care.

All of these resources — along with synthesis reports published previously on accountable care organizations and the medical home, for example — can help you design and implement strategies that will take your organization to the next level of performance in delivering care that is safe, timely, effective, efficient, equitable and patient-centered.

Hospitals and health systems have to stay in top form 24/7 to carry out their important work. The dedication and skill exhibited by hundreds of thousands of clinicians, staff and health care leaders who provide top-notch, patient-centered care to a diverse patient population are unparalleled. This is an ensemble and team that the AHA is proud to support through the next act, the next period of health care transformation.

John Bluford is president and CEO of Truman Medical Centers and chairman of the AHA's board of trustees. You can contact his office at