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In this edition of Healthcare Papers, we begin to understand the scale and pace of the turnaround that the Canadian Foundation for Healthcare Improvement (CFHI) has made in the last three years. During that time, building on a rich legacy of health services research and knowledge transfer, the organization has refocused away from the funding and production of health services research linking producers and decision-makers, which was a hallmark of the Canadian Health Services Research Foundation (CHSRF). The organization has evolved the capacity-building ambitions of its predecessor toward the challenge of directly advancing health services through collaborative improvement initiatives informed by filtered evidence. CFHI has pragmatically adopted elements from leading healthcare improvement collaborative organizations like the Institute for Healthcare Improvement and other improvement initiatives in the US, the UK, Sweden and elsewhere to advance healthcare improvement and performance in Canada in a pan-Canadian fashion. This collection documents the ambitious undertaking of one of its larger improvement efforts to build not just sub-regional or province-wide initiatives, but rather the four-province region of Atlantic Canada, which was joined through a common charter with CFHI as a large laboratory for healthcare improvements. An appropriate laboratory it is indeed, since Atlantic Canada bears the disproportionate burden of illness and poor health outcomes in the West (better The Atlantic Healthcare Collaboration: Is it Time to Challenge the West–East Health Gradient in Canada?