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Incentives required to drive change.

The authors of "Chartbook: Shining a Light on the Quality of Healthcare in Canada," focus on building a Canadian healthcare performance baseline, highlighting opportunities to improve the system and then raising policy questions. This is a thoughtful approach to gaining awareness of the relative performance across the Canadian healthcare system. In essence, it is necessary to first establish a felt need, identify areas to improve and then ensure the system will implement the necessary changes to improve. The authors build a reasonable case for why improvements are necessary, and they identify key barriers that must be removed to actually realize improvements and offer a wide range of policy recommendations. However, not all of these recommendations are focused on the key point of ensuring that there are incentives in place to drive participants to implement changes.