This special report from the Robert Wood Johnson Foundation’s (RWJF) Aligning Forces for Quality (AF4Q) initiative chronicles the program’s ambitious progress.

AF4Q is the Foundation’s signature effort to improve the overall quality of health care in targeted communities, reduce racial and ethnic disparities and provide models for national reform. It asks the people who get care, give care and pay for care to work together toward common, fundamental objectives to lead to better care. The program works to improve health care in 15 communities, that together cover 11 percent of the U.S. population. It is the largest effort of its kind ever undertaken by a U.S. philanthropy.

This report details some of the impressive activities and early results that the communities, as local leaders in the field of health care quality, have collectively achieved in three important areas of focus:

1. Performance measurement and public reporting: using common standards to measure the quality of care that doctors and hospitals deliver to patients and making that information available to the public;
2. Consumer engagement: encouraging patients to be active managers of their health care, and make informed choices about their doctors and hospitals; and
3. Quality improvement: implementing techniques and protocols that doctors, nurses and others in physician offices and hospitals can follow to improve care.