Quality and quality improvement are increasingly common terms found in our clinical practice environment as well as within our research and teaching agendas. In many respects, the dawning of the age of quality and improvement science matches similarly transformative moments in medicine such as evidence based medicine and inter professional care. We will explore the current state of quality in primary care, the building of QI capacity within the discipline and critical success factors. Dr Tepper is a family physician and the president and chief executive officer of North York General Hospital. Previously he was the president and chief executive officer of Health Quality Ontario. Prior to HQO, He was the inaugural vice president of education at Sunnybrook Health Sciences Centre where he was responsible for Sunnybrook’s educational strategy and programming for learners, physicians and staff, patients and their families and the community. Prior to joining Sunnybrook, Dr Tepper was assistant deputy minister (ADM) in the Health Human Resources Strategy Division of the Ministry of Health and Long-Term Care. As the ADM he led the HealthForceOntario health human resources strategy to ensure that Ontarians have access to the right number and mix of qualified health care providers, now and in the future.