Improving quality means pursuing clinical excellence, and when there isn't enough money to do it right, we must refuse to do it. We must challenge the service fad of the month; we must demand rates that cover costs and include training and supervision; and we must resist never ending system re-organization that is proven to have no impact on improving consumer outcomes. We must remember that getting well takes time and money and there are no shortcuts.

We must be committed to practice based upon the best available evidence. We cannot effectively translate science to service unless we design and implement more effective organizational processes that support practice change.

Behavioral healthcare organizations need to collect and analyze data to allow them to ask "How are we doing?" and to use the answers to continuously improve practices and client outcomes. It is this internal feedback loop, organizations and their practitioners systematically collecting and analyzing the outcomes for their programs and the individuals they treat, that can make change in the delivery of care possible. These efforts create a "culture of measurement" and the capacity for "evidence-based thinking" that is essential to the delivery of high quality services.