An introductory letter from RWJF President and CEO Risa Lavizzo-Mourey, M.D., M.B.A.

Each year at the Robert Wood Johnson Foundation we step back and take measure of how well we are living up to the promise of our core mission to improve the health and health care of everyone in America. This is when we demand of ourselves that we practice what we preach about transparency, performance and accountability. The questions we ask test the basic wisdom, integrity and purpose of what we do and how we do it. We ask, for example:

• Are we investing in the right programs the right way at the right time?
• Do we continuously learn and improve?
• Do we achieve the desired outcomes? How do we know?
• Do we gauge success by how hard we work or by the results we produce?
• How do our grantees—our best customers—think we're doing?
• Are we truly making a difference in health and health care?

For nearly 40 years we have been in the business of making that difference. Our aim is to alter and elevate the trajectory of the health and well-being of all our people and to impel American society to change itself for the better. We are blessed with grantees and partners who, with their own genius and energies, help turn this shared mission into reality for communities, institutions and homes all across the country.

In this annual self-examination—it's a diagnostic process, actually—we seek the very best outside-in judgment from hundreds of our grantees, stakeholders and industry leaders. We ask them to (1) independently rate how our performance compares to other major relevant foundations; (2) give us a reality check on the relevance of our priorities and strategies; (3) judge whether we're having the desired impact; and (4) let us know how we can better serve their needs and missions. We seek the plain, unvarnished truth. And each year we get it! 

The 2008 Assessment Report is one element in a broader four-dimension evaluative effort that we keep quietly running throughout the year. Other activities include our Grant Results Reporting, program evaluations and the amazing RWJF Anthology series. Together, they constitute an ongoing real-time systems analysis that is essential to the collaborative successes of grantee and foundation.

Change is what we do, and change is so, so hard. Three decades ago, not long after RWJF's founding, Isaac Azimov wrote:

"It is change, continuing change, inevitable change that is the dominant factor in society today.  No sensible decision can be made any longer without taking into account not only the world as it is, but the world as it will be."

As partners, we are rendering an amazing account of health and health care as they really are.  Through this assessment, seeing ourselves the way we are and the way we are with you, we are better prepared to make health and health care in America as it needs to be.

Risa Lavizzo-Mourey