Qazi, AH Chan PS, Zhou Y, et al. - This study was undertaken to investigate if hospital performance on the risk-standardized survival rate (RSSR) metric was stable or dynamic year-over-year and if low-performing hospitals were able to improve survival outcomes over time. Data were collected from 84,089 adult individuals with an in-hospital cardiac arrest from 166 hospitals with continuous participation in Get With The Guidelines–Resuscitation from 2012 to 2017. Researcheers applied a 2-level hierarchical regression model to estimate RSSRs during a baseline (2012–2013) and two follow-up periods (2014–2015 and 2016–2017). During baseline period, hospital performance on RSSR was generally consistent over 4 years of follow-up. Nevertheless, it was indicated that 1 in 5 bottom-conducting hospitals had a large improvement in survival over time. The data revealed that distinguishing care and quality improvement innovations at these sites may serve opportunities to improve in-hospital cardiac arrest care at other hospitals.