CommonSpirit Health's Innovative Approach to Achieving and Sustaining Clinical Excellence.

BACKGROUND: CommonSpirit Health, a leading nonprofit health system in the United States, provides care to 20 million patients across 158 hospitals and more than 2,200 care sites in 24 states. Achieving large-scale clinical excellence amid inherent variation requires a disciplined approach that is firmly rooted in performance improvement science. METHODS: CommonSpirit developed an innovative eight-step performance improvement approach. This framework includes (1) identifying opportunities via internal/external scans and leadership collaboration; (2) establishing cascaded targets with robust data and benchmarks; (3) ensuring clinical and operational governance; (4) scaling evidence-based standards systemwide; (5) providing comprehensive toolkits and education; (6) implementing performance improvement cycles; (7) multilevel performance feedback; and (8) fostering engagement and accountability. RESULTS: This approach accelerated evidence into practice, achieving top-quartile national performance across numerous quality measures. Systemwide, risk-adjusted hospital mortality significantly declined from 0.93 (28th percentile nationally) in 2021 to 0.64 (66th percentile) in 2024 across 99 acute care hospitals. This translates to thousands of lives saved annually and improved care for more than 400,000 patients in three years. CONCLUSION: CommonSpirit's standardized eight-step performance improvement approach is key to consistently scaling improvement across diverse clinical areas and populations. This replicable model empowers teams to identify, intervene, measure, and achieve substantial, sustainable gains in the quality and safety of care provided. Critical success factors include strong clinical leadership, trained multidisciplinary teams, and consistent, accurate feedback.