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Exercise Objective: To practice linking goal statements with results. Scenario: Many researchers use the CMS database. One study of the first set of Hospi- tal Quality Alliance-reported quality indicators found the following results: Analysis of data from the Hospital Quality Alliance national report- ing system shows that performance varies among hospitals and across indicators. ... [P]erformance scores for acute myocardial infarction closely predicted performance scores for congestive health failure but not for pneumonia. . . . [O]ur findings indicate that quality measures had only moderate predictive ability across the three conditions. Although a high quality of care for acute myocardial infarction pre- dicted a high quality of care for congestive heart failure, the former was only marginally better than chance for identifying a high quality of care for pneumonia. These data do not provide support for the notion that good hospitals are easy to identify or consistent in their performance across conditions. (Jha et al. 2005, 265, 272) For the purposes of this exercise, assume the unit of analysis in the preceding paragraph is one hospital rather than a collective group of Hospital Quality Alliance participants. The results suggest that the hospital approached the improvements in a fragmented, disease-specific manner.