The first conference discussed accreditation as a mode for quality and patient safety, while the second focused on the role of leadership and people in healthcare improvement. The third conference looked at the different domains within healthcare that have to come together to improve quality from education, to information technology, human resources, planning and systems, and financial resources; the fourth conference looked at rebuilding and redesigning quality improvement systems across the continuum of care with focus on the patient, while the last conference in 2019 brought discussions stemming from the previous conferences and focused on how to drive the continuum of healthcare systems form policy to practice.