Efforts to reform healthcare systems around the globe are proliferating rapidly. Two fundamental pressures are driving change - cost and access - and every system is experimenting with measure designed to address these pressures. In the midst of these experiments, serious concerns about quality are being raised. Are efforts to contain costs leading to practices which have a detrimental effect on quality? What, in fact, is quality in the world of healthcare? How should it be measured? How can it be improved? These questions are on the cutting edge of debates about the management of healthcare in the future. This work examines these questions in detail by combining chapters outlining the basic issues with others describing state-of-the-art efforts to measure and manage quality more effectively. The result is a compendium of issues and experiences presented by leading researchers and practitioners which should be of interest to healthcare managers and policy-makers as well as to students and researchers in the field.