Health care organisations are busy with efforts to improve the quality of care on a number of fronts. Many institutions are conducting ‘improvement projects’. Typically these involve the formation of a team around a specific problem and then using the PlanDo-Study-Act (PDSA) cycle to make changes (Langley et al. 1966). Other institutions are applying the principles of quality management and frequently make use of the European Foundation for Quality Management (EFQM) Excellence Model. These quality improvement measures are currently applied at the corporate level of the organisation.