The motivation behind having brilliance as a focus for a project in healthcare is about trying to understand it, and from that, trying to find ways of spreading such understanding widely so that brilliance is more pervasive in health services. One member of the team commented that they had been referred to as running a brilliant team, and responded 'that if that was the case, how bad must the rest have been?' Sometimes it is not easy to see brilliance in what we do, let alone measure it, but on reflection we can remember times when the teamwork was just right, although we did not know it at the time, but now see it as having been a special time. Hugh B MacLeod of the Canadian Patient Safety Institute (CPSI) has been pivotal in inspiring this work, and some of his input is outlined. This paper describes more of the background and motivation behind the project as well as some of the potential ways in which the Health Management Research Alliance (HMRA) is investigating and going about this project. Abbreviations: AI – Appreciative Inquiry; B – Based; CPSI – Canadian Patient Safety Institute; E-BM – Evidencebased Medicine; GBS – Griffith Business School; HMRA – Health Management Research Alliance; HRT – Health Results Team; JHHS – Johns Hopkins Health System; NHS– National Health Service; PGPI – Press Ganey Priority Index; QI – Quality Improvement; SHAPE – Society for Health Administration Programs in Education; UNE – University of New England; UTS – University of Technology Sydney. Key Words: brilliance; brilliant performance; quality improvement; patient safety.