Sullivan et al. make a compelling argument that a "coalition of the willing" must seize the nettle and create a national agenda and the capacity for quality leadership in Canadian healthcare. While there is reason to believe that Canada could benefit from such an agenda, there is also evidence that, if done incorrectly, such an agenda could be expensive and counterproductive. To increase the likelihood that a national quality agenda will contribute to the creation of a sustainable and effective healthcare system, it will be important to understand potential pitfalls and to incorporate approaches that have enabled leading organizations to achieve success. It will be key to create a shared vision of healthcare that focuses on the health needs of our population and engages stakeholders broadly.
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