The Pursuing Perfection Initiative: Lessons on Transforming Health Care

How to cite this paper:

Kabcenell A, Nolan TW, Martin LA, Gill Y. The Pursuing Perfection Initiative: Lessons on Transforming Health Care. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2010. (Available on

The Pursuing Perfection initiative was an eight-year demonstration program (2001 through 2008) funded by the Robert Wood Johnson Foundation (RWJF) in the US. Supported by technical assistance from the Institute for Healthcare Improvement (IHI), the initiative’s goal was to learn if and how health care organizations could make dramatic improvements in performance across the organization, resulting in a considerably more efficient and effective health care system.

Thirteen health care organizations from the US and Europe designed, tested, and implemented changes in strategy, structure, and key processes, supported by IHI faculty and with frequent contact with each other in a collaborative learning model.

All participating organizations were able to demonstrate substantial improvement in at least one area of performance. Equally, the Pursuing Pefection participants learned that two factors are critical to achieving perfection-level performance in health care: 1) substantial changes in the leadership’s approach to quality; and 2) a steady stream of innovative solutions to persistent challenges such as reducing mortality, harm, and disparities. Even though substantial improvements in structure and processes led to better patient experience, organizations participating in Pursuing Perfection could not demonstrate reductions in cost of care and improvements in the health of the community. A different level of innovation is needed to address cost of care and population health.

The Pursing Perfection initiative was an incubator for new approaches to leadership and innovation in health care. With these new approaches, we learned that substantial, sustainable, and replicable improvement in quality is possible in health care organizations. However, for the health system to improve, high quality in health care organizations must, in all likelihood, be accompanied by innovations in the organization of services and care delivery across the continuum of patient care.

Select innovations and results from the Pursuing Perfection initiative are shared in the paper.

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