System transformation addresses this gap by taking a holistic view and integrating quality planning, quality control, and quality improvement into a coordinated approach that strengthens how care is delivered, measured, and improved across the organization.

IHI supports system transformation by pairing two complementary frameworks: the Framework for Safe, Reliable, and Effective Care and the Psychology of Change Framework.

Organizations that pursue system transformation are better equipped to:

• Build a shared sense of purpose, so quality becomes a collective, organization-wide commitment.
• Apply systems thinking to understand interdependence and address root causes instead of symptoms.
• Create opportunities for collective learning and dialogue, where teams can surface challenges and generate new ideas safely and openly.
• Strengthen reflection and personal inquiry, helping individuals recognize assumptions and adopt more adaptive ways of thinking.

IHI Care Operating System
IHI CareOS connects clinical care, operations, and analytics in real time helping care teams reduce variability, improve outcomes, and address the root causes of clinician burnout. 

Discover IHI CareOS→ 

Whole System Quality
From governance to frontline care, IHI implements a holistic approach to quality management that aligns system-wide goals, builds improvement capability, and supports continuous, sustained progress. 

Explore Whole System Quality→ 

Explore how IHI’s frameworks and resources can advance system transformation throughout your organization.

• See the Framework for Safe, Reliable, and Effective Care→ 
• Explore the Psychology of Change Framework→