Moderator: Stuart Guterman, PhD, The Commonwealth Fund
Panelists:

• Thomas E. Hamilton, MA, Centers for Medicare & Medicaid Services (CMS)
  
• Stephen F. Jencks, MD, MPH, Institute for Healthcare Improvement (IHI), CMS
  
• Duncan Moore, PhD, University of Iowa College of Public Health
  
• Stephen R. Mayfield, MBA, MBB, American Health Association
  

Dr. Guterman started the discussion by summarizing the messages throughout the day:

• Top level involvement is needed
• Communication between the top level and medical staff is critical to carry out strategy
• Objectives need to be clear, procedures in place, and resources available
• Medical staff need to pressure leadership where these things are not in place