Vision, commitment, and leadership are important, yet they can't improve quality of care in and of themselves. It takes knowledge, talented and prepared people, and action-lots of action-based on carefully constructed analyses and plans.

It is a treasure when all of these pieces come to life together in one system. Such is the case within Covenant Healthcare Systems, Inc. (CHSI) in Milwaukee, WI, a part of the Wheaton Franciscan System (WFSI) of Wheaton, IL.

This issue of the Journal of Nursing Care Quality is a collection of papers reflecting improvement initiatives in one integrated delivery system. Some of the benefits of an integrated delivery system are the ability to leverage learnings, to pull together the best and brightest talent from multiple sites to generate better solutions, and to work together to create a synergistic approach to improvement. Covenant Healthcare also happens to be the health care system in which I am privileged to practice. It is with great respect that I recognize the many talented individuals who make up this vital organization. A small part of their important work is captured in the following pages. These papers reflect improvement projects that span the continuum of care and spectrum of entities that make up the organization as a whole, from ambulatory care to acute care, to long-term care, sometimes individually and sometimes all within the same body of work. The papers also reflect site-based initiatives, as well as cross-site initiatives. They reflect the momentum that can be captured and driven, even during these times of rapidly changing demands and workforce challenges within the chaotic health care environment. My congratulations to these champions.

My acknowledgment to the visionary leadership of Paul Dell Uomo, CEO of CHSI, and John Oliverio, CEO of WFSI.

-Patricia Schroeder, RN, MSN, MBA

Journal Editor