This is the fourth book in a series designed to share innovations in patient care. It includes improvement approaches selected by two senior leaders at the Institute for Healthcare Improvement. These proven strategies are reliable, innovative, and ready for implementation. Ideas explored in this book include: * Harnessing and leveraging the power of middle managers * Assigning personal guides to help patients and their families navigate the treatment process * Using simulations to provide technical skills training to staff and promote behavioral and cultural change * Engaging board leaders in patient safety and quality initiatives.