 This study examined the effectiveness of improvement interventions in healthcare organizations, focusing on both low-performing and high-performing organizations. It found that interventions were often designed around the organization itself, rather than considering the larger system in which it operates. This can lead to a narrow focus on organizational restructuring or senior leadership changes without considering the potential negative consequences of these interventions. Additionally, there has been little consideration given to the cost of implementing these interventions compared to their impact on quality of care. This article was authored by Cecilia Vindrolopodros, Jean Ledger, Estella Capella's Barbosa, and others.