Any judgment of hospital performance must obviously be based upon securing an expression of the adequacy with which the complex function suggested above are discharged in relation to the opportunities open. Hospital performance serves as a criterion of the standards of medical and nursing practice of a community and judgment of such performance is moral, not mechanical. Success in hospital betterment is conceded to be largely dependent upon proper local leadership and self-standardization and any suggestion for the development of such leaders is aiming at a fundamental contribution to the entire program.