The healthcare systems of most developed nations face a common challenge: a substantial gap exists between the best possible care and the care routinely delivered. Numerous studies in the literature and reports from authoritative bodies, such as the Institute of Medicine (IOM) in the United States, have provided compelling and persuasive evidence that care is not consistently safe, timely, effective, equitable, efficient or patient-centred. A landmark study published in 2003 reported that Americans receive recommended care 54.9% of the time (McGlynn et al. 2003). The recent survey conducted by the Commonwealth Fund of sicker adults in six countries - Australia, Canada, Germany, New Zealand, the United Kingdom and the United States - underscores the pervasive challenges of providing high-quality care. The differences between the six countries pale in contrast to the common theme of significant opportunities for improvement in all nations (Schoen et al. 2005).

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