Perhaps the most significant and representative research project to improve the care of the elderly has been demonstrated with "Community Centers of Excellence for the Aging." (CCEA) Since 1993, the John A. Hartford Foundation has supported this project and its successors to create better partnerships between patients and their doctors by enhancing better communication, educating patients about their health, increasing physician awareness about health needs of their patients and responding to unmet needs... ultimately improving the quality of life for the elderly. Using the Dartmouth COOP Clinical Improvement System as well as the "Improve Your Medical Care" questionnaire the intervention has yielded positive results. Eighty percent of patients believe that the quality improvement approach has improved their health, and that their clinicians have become more aware of important and otherwise unmet patient needs. More patients are aware of preventive measures, such as flu shots, and many patients now have advance care plans. There is improved knowledge about home health hazards and about the importance of keeping track of medication. Patients who have begun to exercise say that they feel much better.