Foundation Program Sites

We help the healthcare community find common ground.

For over 30 years the Foundation has been a trusted, independent resource to all participants in the health care community – patients, providers, payers, employers, hospital leadership and government agencies. We believe that healthcare quality improvement is in everyone’s hands.

We are a non-profit organization made up of seven programs, the Robert Bree Collaborative, the Washington Patient Safety Coalition and four clinical Care Outcomes Assessment Programs (COAPs) and Smooth Transitions, all with the same goal: how can we provide safer, better care for patients.

We also undertake consultative projects that require discretion, sensitivity and political neutrality. Recent clients include One Health Port, Noridian, and Yale University. 

Our Programs

The Robert Bree Collaborative is focused on developing guidelines to help with the core principles for appropriateness of care and evidence-based practice. The Bree Collaborative was established in 2011 by the Washington State Legislature with the goal of providing a mechanism through which public and private health care stakeholders can work together to improve quality, appropriateness of care, fitness for surgery, safety, health outcomes, and cost-effectiveness of care in Washington State. The Bree Collaborative areas of focus include cardiovascular surgery, spine surgery, opioid use, obstetrics, oncology care, and many others where there is significant variation in quality, cost and utilization. Recommendations are used for healthcare purchasing and to set a standard of care for Washington State.

The Washington Patient Safety Coalition (WPSC) acts as a neutral hub uniting a diverse range of healthcare stakeholders to achieve common patient safety goals. A member-based program, the WPSC is made up of 40+ organizations representing healthcare systems, associations, and advocacy groups across the state of Washington. Representatives from these organizations sit on our committees, helping to shape the direction and activities of the WPSC. 

Our COAP collaboratives are dedicated to a specific clinical specialties and are unique in that they are clinician-led and driven by successful data-driven collaboration. The COAPs have proven incredibly effective at promoting changes that result in improved quality and patient safety and reduced variability in process and outcomes. These collaboratives use chart-abstracted data from medical and surgical services to provide member hospitals with the data they need to drive continual improvement of health care that meets or exceeds established standards.  

  • Cardiac Care Outcomes Assessment Program (COAP)  
  • Surgical Care Outcomes Assessment Program (SCOAP) 
  • Spine Care Clinical Outcomes Assessment Program (Spine COAP)   
  • Obstetrical Care Outcomes Assessment Program (OB COAP)  

Provider-specific, chart-abstracted data serve as the basis for analysis and discussion within and across participating institutions. COAPs provide an opportunity to participate in regional learning collaboratives that give providers an active role in the quality improvement process. The ability to discuss and learn from others’ experiences create opportunities for actionable and sustainable improvements to reduce variation. By having access to accurate, nearly current clinical data, participants can respond to and facilitate changes that address issues with both quality and resource use components.

Smooth Transitions is a Washington state-based quality improvement program enhancing the safety of hospital transfers between home or freestanding birth centers. They bring together community midwives, hospital providers and staff, and EMS personnel to build a collaborative model of care that puts birthing families at the center. They offer presentations throughout Washington State and provide direct support to participating hospitals, and are available to consult with perinatal collaboratives and organizations in other states interested in replicating this work.








Dr. Robert Bree

The Foundation’s resources are used frequently to bring together people with varied perspectives around a shared goal: the continual improvement of sustainable health care that meets or exceeds established standards.

We invite you to learn all you can about our work, and to contact us if you have comments or questions, or if you wish to become involved.