Based on existing research and observations, ten characteristics of high-performing healthcare organizations are identified. These include a willingness and ability to: stretch themselves; maximize learning; take risks; exhibit transforming leadership; exercise a bias for action; create a chemistry among top managers; manage ambiguity and uncertainty; exhibit a "loose coherence;" exhibit a well-defined culture; and reflect a basic spirituality. Numerous examples are provided reflecting the above characteristics, and the ability of excellent healthcare organizations to meet future challenges is discussed.