Signalling the importance of healthcare quality and quality improvement plans in Ontario, the province's Excellent Care for all act requires all hospitals to publish quality improvement plans, conduct regular patient and staff surveys, and forge a clear link between hospital CEO compensation and quality improvement. The act also clarifies and strengthens links between evidence and quality of care. The act is an important step toward Ontario's becoming a high-performing healthcare system. Yet as some of the papers in this special issue of Healthcare Quarterly discuss, there remains much to be done. Other papers and interviews draw attention to the importance of strategic and system design levers--particularly setting goals, public reporting of results and clinician engagement--to stimulating improvement. Yet other papers present a diverse range of perspectives and ideas on how to pursue improvement and to bridge the knowing-doing gap in healthcare so that evidence informs better practice. Achieving and sustaining high performance in healthcare will require dedicated effort by everyone in every healthcare organization. With a view to the future, the act allows for the expansion of the quality obligations initially applicable to hospitals to other publicly funded health organizations.
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