While the pressure to achieve organizational excellence exists in every sector, there are few in which that pressure is as intense and the stakes are as high as in healthcare. On one hand, there are the patients and their families who expect high-quality services. On the other, the reality is that healthcare is a business. And it is the executives and directors of these healthcare organizations who are left to operate amid this constant tension, with the pursuit of excellence as a central and ongoing priority.

But what does ‘excellence’ look like in healthcare? And, perhaps more importantly, how does a healthcare institution maintain a state of excellence over the long term without slipping into a spiral of organizational decline?

These are some of the questions we pursue in this report. Specifically, this report explores why some organizations struggle to detect the warning signs of decline, the telltale signs of decline and what organizations can do to prevent it from occurring in the first place.