Getting physicians and surgeons to change their entrenched practice patterns is one of the hardest journeys a hospital can face, but it's often vital to making patient care better. Actionable information, physician-to-physician engagement and a clinically credible and experienced third party can remove many rocks from the road. St. Dominic-Jackson Memorial Hospital in Jackson, MS has dramatically improved its cardiovascular care program by developing a collaborative multidisciplinary approach targeted at the highest risk patients. Though the approach is straightforward, getting physicians to accept that their current approach could improve, and then change the way they approached this risky population, was anything but. With the aid of HealthGrades Clinical Excellence Research and Consulting group, St. Dominic's was able to translate opportunities identified from multiple data sets, chart review and physicians into deliberate and focused process improvement. The 571-bed hospital's wake-up call was a report from HealthGrades, which is nationally known for analyzing Medicare outcomes data and other publicly available information. St. Dominic's 2004 mortality rates for several cardiac care areas, including bypass procedures, valve replacements and treatment of heart attacks, were worse than they should have been. Everyone-the administration, the board, and the medical staff-agreed that something had to be done.