Article-at-a-Glance Background In 1999 King Chulalongkorn Memorial Hospital, a 1,500-
bed teaching hospital in Thailand, started planning and implementing a hospitalwide quality
improvement program, as required for accreditation. Deploying the Nine-Step Ladder
Strategy The steps in the strategy were as follows:(1) ensure commitment and formulate
mutual strategies;(2) develop teams, technical staff, and support;(3) pilot new improvement
activities and expand existing quality programs;(4) improve core systems and functions;(5) …