Our life outcomes are powerfully determined by seemingly trivial, repeated acts. Our health, for example, depends on thousands of daily choices-to eat well and exercise regularly, to avoid smoking, and to take medications as prescribed. Yet 40 percent of premature deaths each year result from suboptimal behavior. The authors argue that the most promising avenue for making behaviour change 'stick' is to take proactive steps to change our habits. They provide advice for achieving this by 'targeting the situation' and 'shifting cognitions'. In the end, they show that there is an enormous untapped opportunity at hand to enable sustained improvements in daily decisions on a collective level.

Asking people to rate themselves has obvious disadvantages: They could fake their way to a higher score, or they might lack self-awareness. But self-report surveys make data collection efficient and offers access to respondents' thoughts, feelings, and behavior. Another benefit many people don't consider: The act of answering the questions can promote greater self-awareness, opening the door to self-development.

Grit, a combination of passion and perseverance, predicts success in many demanding fields. A perfect example is health care, where the grit of individual doctors and nurses has saved many lives. But today providing superior care is so complex that no lone practitioner can do it all. Great care requires gritty teams that never stop striving for improvement and institutions that exhibit grit across entire systems of providers. In this article Duckworth, the author of the best seller Grit, and Lee, a clinician and health care leader, describe health care's new model of organizational grit. It begins with hiring people with grit--who love what they do, always want to get better, and are resilient in the face of setbacks. Their single-minded determination stems from a clear personal-goal hierarchy, in which shorter-term objectives support a top-level goal that gives direction to everything they do. To be gritty, organizations must have a similar clarity about priorities, and their top-level goal and their employees' must be aligned. If everyone is pursuing a separate passion, a culture won't be gritty. The gritty health care organizations the authors have seen (such as Mayo Clinic and Cleveland Clinic) all make "putting patients first" their overarching goal and use it to guide every decision. They also work to cultivate grit by, for example, setting high expectations; offering the resources, support, and trust people need to keep learning and growing; and establishing strong social norms that promote their top-level goal. While the objectives of organizations in other sectors may differ, they can apply the principles the authors outline here to become gritty, too.