March 22-25, 2016, all 4 hospitals of UW Medicine, University of Washington Medical Center (UWMC), Northwest Hospital, Valley Medical Center and Harborview Medical Center became the first health system in the country to have all of its hospitals achieve Joint Commission Advanced Palliative Care (PC) Certification. UWMC originally was certified in 2014 under the leadership of Dr Jackie Raetz, in the DFM, and recertified in 2015 and again in 2016 under the leadership of Dr Lu Marchand, section chief of PC in the UW Department of Family Medicine, and director of the UWMC PC program, and Dr. Jim Fausto, associate director. All of the three other hospitals certified for the first time in PC. All 4 hospitals demonstrated strong interdisciplinary clinical care and teaching, with resulting excellent clinical care. Quality metrics in PC were presented by Helene Starks and Kelson Okimoto, the operations manager of the PC service and section in PC. Team members of each PC service were critically involved with preparing for this certification and events during the survey. Dr Wayne McCormick and Lisa Robinson were instrumental in organizing joint commission efforts at all 4 hospital. Job well done!