Excellence in American hospital care is rare. It is common knowledge that many hospitals fall alarmingly short on safety, quality, effectiveness, patient satisfaction, and cost. As Mark Chassin wrote in Health Affairs, "quality and safety problems in health care continue to routinely result in harm to patients. Desired progress will not be achieved unless substantial changes are made to the way in which quality improvement is conducted." What exactly should those "substantial changes" look like? Hospitals seeking excellence are pursuing various paths, but the best documented and most comprehensive is the "Baldrige journey"
