In a special issue of Health Affairs, researchers examine the persistent challenges facing the U.S. health care system with respect to closing the gaps in quality and safety of care.

The papers appearing in this special issue present a mixed picture of health care quality. Some leading health systems are making strides at improving quality and safety of care and lowering health care costs. Their success lies in dramatic changes, such as creating new cultural norms and mobilizing a wide variety of stakeholders in the change process. Additional papers describe key components of future quality improvement efforts and challenges that lie ahead.

Funded by the Robert Wood Johnson Foundation, the issue also looks at the profound costs incurred by shortfalls in quality, the optimal ways to measure quality, and the most successful ways to date of improving the quality of care.