The Cleveland Clinic has long had a reputation for medical excellence and for holding down costs. But in 2009 Delos “Toby” Cosgrove, the CEO, examined its performance relative to that of other hospitals and admitted to himself that inpatients did not think much of their experience at its flagship medical center or its eight community hospitals—and decided something had to be done. Over the next three years the Clinic transformed itself. Its overall ranking in the Centers for Medicare & Medicaid Services (CMS) survey of patient satisfaction jumped from about average to among the top 8% of the roughly 4,600 hospitals included. Hospital executives from all over the world now flock to Cleveland to study the Clinic’s practices and to learn how it changed.

A version of this article appeared in the May 2013 issue of Harvard Business Review.