ELLEN J. GAUCHER is group vice president for operations/quality and customer satisfaction at Wellmark, Inc., Blue Cross and Blue Shield of Iowa and South Dakota. She is associate editor for Aspen's Quality Management in Health Care and serves as a board member of the Institute for Healthcare Improvement. RICHARD J. COFFEY, Ph.D., is director of program and operations analysis, and director of research and planning, at the University of Michigan Health System, Ann Arbor, Michigan. He has served in staff, consulting, and leadership roles in many university and community health care, consulting, government, insurance, and private organizations for nearly thirty years.Gaucher and Coffey have co-authored two award-winning books. The first, Transforming Healthcare Organizations, won the 1992 James A. Hamilton book-of-the-year award from the American College of Healthcare Executives. The second, Total Quality in Healthcare, won the American Nurses Association book-of-the-year award in 1993.