The American Hospital Association-McKesson Quest for Quality Prize celebrated its 10th anniversary this year by honoring five hospitals for progress in achieving the Institute of Medicine's six quality aims. Their journeys reflect a rich understanding of how to inculcate an organizationwide culture committed to continual improvement in safety, effectiveness, efficiency, timeliness, patient-centeredness and equity.

On behalf of the committee, thanks to all the hospitals that applied in the past 10 years. You have raised the bar each year, showing creativity, innovation, a willingness to share what works and the wisdom to steal shamelessly the proven approaches from other pioneers. In the hope of accelerating the quality journey of all hospitals, I offer the following observations gleaned from the committee's experiences over the past decade:

Board leadership | Consider a retreat focused on the six quality aims and how they relate to your hospital's goals. Invite board members to participate on quality improvement teams and bring the patient experience to the board by inviting patients to meetings to tell their stories. And don't overlook the expertise board members can bring — many improvement tools, such as Lean, Six Sigma and Red Rules, came from other industries.

Don't believe your own press releases | High scores on publicly available data and being on the top 100 lists can be important, but they don't, for example, consider whether process change is being implemented top-down and bottom-up or how culture is changing to create a patient-centered, high-reliability environment.

Patient-centered care | It's time to move beyond focus groups to real involvement. There's more recognition that patients and their families are part of the health care team and should participate in their own care … as well as in designing care by participating on committees and on improvement teams.

Equity | Striving for equity requires addressing diversity, going beyond cultural sensitivity. Look at your board, your medical staff, hospital employees and volunteers — does their ethnic and racial composition mirror that of your community? And does your patient mix also mirror that of your community?

Beyond the hospital walls | How is your hospital improving the health of the community? How and what are you measuring? Screening and health fairs are a start, but you also must work with community partners to address local factors affecting health status. Often, the answer is not traditional services — it's making fresh fruits and vegetables available, providing safe areas for exercise and play, or getting children into water safety and swimming classes.

The AHA-McKesson Quest for Quality Prize Committee congratulates the 2011 winner, Memorial Regional Hospital, Hollywood, Fla.; the 2011 finalists, AtlantiCare Regional Medical Center, Atlantic City, N.J., and Northwestern Memorial Hospital, Chicago; and the 2011 Citation of Merit honorees, Providence Little Company of Mary Medical Center Torrance (Calif.) and Virginia Mason Medical Center, Seattle.

For more information and the 2012 criteria and application, go to We encourage all hospitals to apply. Applications are due Oct. 9.

Jeffrey D. Selberg is executive vice president and chief operating officer of the Institute for Healthcare Improvement. ?You can contact our guest author at