The Alaska Native Medical Center, one of nine teams that participated in the Institute for Health Care Improvement's Community-Wide Learning Collaborative, used quality improvement principles to address a disparately high post-neonatal infant mortality in the Anchorage Native infant population. A unique concept, "Days Between Deaths," was used to measure mortality change for a small data set. Ongoing evaluation processes have demonstrated a fifty percent reduction in infant mortality and very successful approaches to care for high social risk women and their families.