Unless we are willing to take a long-term look in terms of the implementation of TQM in our health care system, TQM will not work. QI is badly needed in health care, but quality is a slippery concept and requires continuous monitoring and commitment from all of us who embrace it. However, the suggestions provided in this article may assist in adopting and implementing such programs. Furthermore, the articles that follow in this issue will show how the concepts incorporated in the implementation of the TQM process can be successfully applied to a health care setting.