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In 1994, the American Nurses Association initiated a series of activities currently referred to as Nursing's Quality Initiative. This first step toward public accountability was based on the premise that all nurses must become more knowledgeable about the measurement, improvement, and benchmarking of clinical costs, quality, and outcomes specific to nursing. The American Nurses Association has not been working alone to advance quality health care. Rather, it has taken an active role in several collaborative activities, including those of the National Quality Forum. The National Quality Forum has focused on a variety of issues, including nursing care performance measurement, an activity in which the American Nurses Association has been involved. It is up to professional nursing, the National Quality Forum, and all who have interest in the provision (or receipt) of quality health care to advance quality in a collaborative, coordinated way.