This paper reviews five health care systems that are viewed as ‘high-performing’, using cross-case methods to identify the key factors linked to their success, examining their leadership strategies, organisational processes and the investments they made to create and sustain improvements in care.

The author asserts that developing a high-performing system is a journey that cannot be judged solely by examining current performance. Instead, we must assess the environment and challenges the organisation faced; understand the strategies and investments its leaders made; and assess the learning, mid-course corrections and current efforts made to maintain and spread high-performance.

Download: The roles of leaders in high-performing health care systems