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Our funding for updating this website ended in 2011, but the resources we developed are still helping clinical practices from around the world to transform the care they provide to better serve patients with chronic illness. Please visit our home page to learn more—or check out our more recent tools and resources at:


Health System

Create a culture, organization and mechanisms that promote safe, high quality care
  • Visibly support improvement at all levels of the organization, beginning with the senior leader
  • Promote effective improvement strategies aimed at comprehensive system change
  • Encourage open and systematic handling of errors and quality problems to improve care (2003 update)
  • Provide incentives based on quality of care
  • Develop agreements that facilitate care coordination within and across organizations (2003 update)
A system seeking to improve chronic illness care must be motivated and prepared for change throughout the organization. Senior leadership must identify care improvement as important work, and translate it into clear improvement goals and policies that are addressed through application of effective improvement strategies, including use of incentives, that encourage comprehensive system change. Effective organizations try to prevent errors and care problems by reporting and studying mistakes and making appropriate changes to their systems. Breakdowns in communication and care coordination can be prevented through agreements that facilitate communication and data-sharing as patients navigate across settings and providers.