Case Material Supporting Checklist Items

The cases presented here are more detailed descriptions of our institutions’ experiences implementing the 10 Checklist items, along with follow-up contact information for additional conversations.

Foundational elements

imageGovernance priorityvisible and determined leadership by CEO and Board

CASE Leading Commitment to Value at Virginia Mason Health System

In order to better orient its leaders toward quality, Virginia Mason (VM) Health System leadership and the Board of Directors developed a new strategic plan that adopted the business case for quality as a key strategy with an unequivocal focus on the patient. Responsible governance is a foundational element of VM’s strategic plan. VM’s board, comprised of a wide range of community members, is ultimately responsible and accountable for the organization’s success.

Responsible governance means a Board that is committed to doing everything necessary to ensure a clinically superb, fiscally healthy, and innovative environment. At VM, this means that:

  • The Board receives regular education about health care quality issues
  • The Board is structured to emphasize quality
  • The Board spends significant time at each of its meetings attending to quality
  • Executive review and compensation are tied to specific quality metrics
  • The organization can demonstrate improvements in quality and outcomes during the last 3 years
  • Focus on quality is evidenced in the Board’s approach to finance—both in terms of capital allocation and operating priorities


Virginia Mason received the inaugural Leapfrog Governance for Quality Award (an award given to one hospital or health system in the country annually) for the work its Board has done to mobilize the organization to improve the quality of patient care.


Please contact: Lynne Chafetz, JD (

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