Accelerating Healthcare Improvement: CFHI’s Assessment ToolTM for Healthcare Delivery Organizations and Systems


“Every system is perfectly designed to get the result it gets.”
Paul Batalden, M.D.


Download the Assessment Tool (PDF)

How can an organizational assessment tool help?

CFHI created this assessment tool to help healthcare leaders assess their organization’s or system’s capacity to undertake improvement initiatives.

The tool is built around six levers that will guide your organization toward making the changes needed to become a high-performing healthcare organization. For each lever (see Figure 1), the tool includes statements that help you assess where your organization or system currently performs. These levers were developed after an examination of the key attributes of three high-performing healthcare organizations — Southcentral Foundation in Alaska, Jönköping County Council in Sweden, and Intermountain Healthcare in Utah (read the full paper) and a review of Canadian literature on healthcare transformation (read the full paper).
Learn how to you use the tool.

Through assessment, this tool will help your organization or system:

  • Identify your improvement expertise, assets and strengths;
  • Understand your organization’s capacity to identify improvement efforts and amplify them;
  • Enable and accelerate healthcare improvement; and
  • Take next steps for improvement.


CFHI's 6 Levers for Healthcare Improvement Diagram

Figure 1. CFHI's Six Levers for Healthcare Improvement

Focusing on population needs

Understanding the population you serve (e.g., conducting a needs assessment of your catchment area) to provide the right care, at the right place and at the right time.


  • Our organization monitors its performance against its population health goals.
  • Our organization addresses the varying needs of its patient population.

Engaging healthcare providers and front-line managers in creating an improvement culture

The clinical front-line can become agents for improvement and help build a culture committed to providing better care, better health with better value-for-money.


  • Our organization engages all types of healthcare providers and front-line managers to develop clinical leadership for improvement initiatives.
  • Our organization regularly communicates change and priority objectives for change within its units.

Building organizational capacity

Creating self-reliance for improvement within your organization involves skilling up staff in healthcare improvement, giving them the ability to identify necessary improvements based on evidence, supporting them in implementing these changes and recognizing them for doing so.


  • Our organization has a quality improvement framework that guides its efforts.
  • Our organization makes relevant, timely, performance data available to healthcare providers, front-line managers and senior leaders to support improvement.

Creating supportive policies and incentives

Implementing organizational policies to ensure a healthy workplace and supporting employees to acquire and use improvement skills are the kinds of incentives required to move toward sustainable high performance.


  • Our organization aligns its improvement efforts with the Accreditation Canada standards.
  • Our organization promotes a safe and healthy workplace (e.g., flexible work hours for staff).

Engaging patients and citizens

Patients and families can drive quality improvement and enable your organization to tap into a wealth of ideas and knowledge about the design, delivery and evaluation of services.


  • Our organization encourages its patients to play a defined role in establishing improvement goals.
  • Our organization defines and measures the patient improvement goals.

Promoting evidence-informed decision-making

Healthcare providers and their managers have access to up-to-date information and are trained in finding, assessing, adapting and applying data and evidence for improvement.


  • Our organization has resources dedicated to finding and synthesizing evidence to better support its front-line managers and healthcare providers’ decision-making (e.g., knowledge brokers).
  • Our organization has a strategy to develop healthcare providers and front-line managers’ ability to find, assess and apply the best available evidence in delivering services.

How do you use the tool?

Here are some suggested steps for using this tool. A Readiness Checklist to support this process is available upon request.

  1. Identify a team of healthcare leaders — responsible for the management, financing and delivery of care — who will use the tool. After individual review (or even completion) of the tool, come together to review the Six Levers for Improvement and work on capturing your answers, discussing each point as you go along. For certain sections of the tool, you may want to include other individuals, such as front-line managers and clinicians (e.g., for the engaging healthcare providers and front-line managers in creating an improvement culture section) as well as patients and citizens (e.g., for the engaging patients and citizens section).
  2. Collate your answers. You will need to refer back to them during the Discussion phase.
  3. Consider suggestions identified in the “What’s Next?” section as these prompts may assist you in auctioning your results.