Book excerpt: Written by the CEO and senior vice president of a 20,000 employee health care system, this book chronicles the journey that these healthcare leaders took when implementing continuous quality improvement (CQI) throughout this 27-hospital system. the authors candidly share their thoughts, challenges, and evaluation of what happened, and also how the hospitals in the system and its employees at all levels were impacted by the process. a book in the ASQ Health Care Series, this realistic and practical account conveys how the authors came to believe CQI could positively transform the organization and how they designed the structures needed to implement it. They also share the ups and downs they experienced and provide 10 tips to consider when implementing CQI. the appendix includes the SSM Health Care System CQI manual, showing some of the actual forms and guidelines used during implementation, and the foreword is by Donald M. Berwick, M.D. SSM Health Care System (SSMHCS), one of the largest Catholic health care systems in the United States, is committed to CQI. the top leaders of this St. Louis based organization provide a candid look at the possibilities, opportunities, and ramifications of CQI. Their purpose is to give business leaders the information they can easily relate to and begin using immediately. ABOUT the AUTHORS: Sister Mary Jean Ryan, FSM is the president and CEO of SSMHCS, based in St. Louis, Missouri. a recognized leader in health care, her responsibilities include coordination, direction, and integration of all the activities of SSMHCS. She earned her Masters Degree in Hospital & Health Administration from Xavier University. William P. Thompson is senior vice presidentustrategic planning, of SSMHCS. He is also a member of the executive committee for the Quality Management Network. Mr. Thompson has an M.H.A. Degree from Saint Louis University.