National quality framework - yes we can!

This commentary provides perspectives from the nursing profession on the lead article that address professional and regulatory issues and shares insights derived from many years of leading quality enhancement initiatives at policy and clinical levels. The commentary calls attention to a number of successful national and provincial approaches founded on strong leadership, collaboration and consensus building. It also underscores the idea that professional organizations and individual health professionals are important drivers of quality initiatives at the point of care and when overseeing adherence to standards and successful program implementation.

The role for advanced practice nursing in Canada.

The delivery of modern health services is a complex activity that increasingly relies on inter-professional collaboration. The different roles of the members of these inter-professional teams may depend not only on traditional job demarcations but also on a division of labour that maximizes efficiency and improves outcomes.

Focus on healthcare: a wider lens.

Achieving greater healthcare efficiency requires a much better understanding of the relationships and processes that occur between the inputs and outputs of the system. It also requires a broadening of the lens to include the determinants of health. The answers to many of the questions posed by the authors of the lead article lie in research, a key area of needed investment if Canada is going to respond to the value-for-money challenge.