This paper discusses the current state of health care quality and describes some of the factors that are hindering efforts to move toward evidence-based practice. The President's Advisory Commission on Consumer Protection and Quality spent one year looking at the state of health care quality and developed a set of recommendations to tackle the serious quality problem in the health care industry. The Institute of Medicine has started an initiative, Quality of Health Care in America Project, which is addressing many of the quality of care areas identified by the President's Advisory Commission on Consumer Protection and Quality. This paper discusses the work of these two groups and concludes with key issues in the advancement of quality health care.