A half decade has elapsed since the Institute of Medicine released 2 landmark reports on health care safety and quality, To Err Is Human1 and Crossing the Quality Chasm.2 Those studies helped articulate a broad agenda for quality improvement in health care, and examples of success on a small scale are numerous. However, the collective impact of improvement work has been far below the potential envisioned by the Institute of Medicine. Health care can benefit now from a new sense of urgency, with levels of discipline and pace akin to those of a political campaign.