Since publication of the IOM report "To Err is Human," the goals of safe, effective, patient-centered, timely, efficient, and equitable health care have become the mantra for laboratory quality. Increasingly, healthcare purchasers, patients and payers are demanding accountability. In this issue of Clinics in Laboratory Medicine, we will address opportunities for quality improvement throughout the testing cycle with the goal of enhanced clinical effectiveness and improved patient outcomes. Discussions include opportunities for improvement as well as quality reporting and the development of quality measures, lessons learned from the nation's first experience with building an institute for laboratory quality, dangers of false positive and false negative test results, measurement of quality in anatomic pathology, electronic data interface and interoperability, among other highly relevant topics intended to serve as a useful reference for laboratory professionals and others engaged in quality improvement efforts.