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Many health systems suffer from having too little data to identify significant quality improvement opportunities, while others suffer from the confusion of having too much.

Award-winning healthcare organizations have used the following four tactics to move quality to the top of the hospital agenda: Leverage the strategic plan to support the organization's quality and safety goals. Use "budget-like" tactics to set quality and safety goals. Emulate the finance model of reporting and accountability to meet quality goals. Base a portion of incentive compensation, salary adjustments, and annual performance reviews on the achievement of quality-related goals.

The effectiveness of a quality improvement (QI) program developed by Spectrum Health in Grand Rapids, Mich., is in many ways exemplified by its Acute Myocardial Infarction/Percutaneous Coronary Intervention (AMI/PCI) Improvement project, launched in 2003. Team structure played a major part in the AMI/PCI Improvement project's success. Indispensable members of the project team included two medical directors and a nursing director serving as team co-chairs, a quality medical director, a QI specialist, a data analyst, and a financial analyst.

To dramatically improve quality while decreasing costs, hospitals should: ensure all executives are vocal and visible supporters of quality improvement; focus the board of directors on quality as a strategic priority; strategically target quality resources to improve care for the majority of patients; use the finance system as the foundation for automated quality reporting; form a strong alliance between the CFO and chief quality officer, with each playing a leadership role in the quality program; rely on a well-executed quality program to improve efficiency and decrease the cost of care.