The challenge of quality improvement at the system level. Whither CCO?

Cancer Care Ontario has made significant strides in the improvement of access to high-quality cancer care by putting in place the basic elements of transformation: a clear plan, reporting against this plan and clinician engagement. However, as our health system changes so must improvement efforts. Greater focus on equity and population health will require a better understanding of the people served. The increasing need for improvement will put a premium on quality improvement skills. Finally, the need to re-engineer care across the patient journey will require attention to integration; attention that will have to come from government.