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The author calls for a critical assessment of the impact of investments made in the measurement of quality and safety, and reflects on whether a reorientation of some of this investment is required to realize the healthcare quality and safety improvement the system seeks. This article also reflects on several Canadian initiatives that have been typical and draws on the experience of health systems that have used measurement to great effect to suggest how investments in healthcare quality and safety measurement should be focused in the future.

Measurement of Quality and Safety in Healthcare: The Past Decade and the Next