Performance improvement initiatives may occur at various levels, including local organisations, specified geographic or administrative regions (eg area health service or state), and national and international levels. The aim and focus of measurement varies accordingly. At any level, performance assessment is about measuring against a specified standard. It may include measures to determine how well an organisation or system performs on identified dimensions in terms of its defined goals and objectives. These dimensions are numerous and vary in accordance with organisational size and complexity, type of services delivered, the stakeholders, and other characteristics of the organisation. For example, a teaching hospital might assess its performance on such dimensions as effectiveness, appropriateness, efficiency, safety, capability, accessibility and equity, Another organisation could assess performance on whether it provided improved health to customers, accurate and timely information for consumers on service delivery, and responsiveness to the expectations of populations.