This Joint Commission annual report shows continued improvements in quality of care in hospitals across the United States. This year's list of Top Performers included a record 1224 hospitals, representing nearly 37% of all reporting Joint Commission-accredited hospitals. Even as The Joint Commission has added new accountability measures over the past few years for stroke care, venous thromboembolism, perinatal care, and immunizations, the number of hospitals reaching at least a 95% composite accountability score has more than tripled in the past 4 years. Major gains were found this year in the quality of perinatal care, children's asthma, venous thromboembolism, and inpatient psychiatric services. Heart attack care now has a composite score of 99%.