Boards and executive leadership have a dominant but unique role in improving the quality of care and ensuring patient safety in their organizations. Much is underway with respect to quality initiatives in the industry, but most activity is taking place at the clinical and management levels. More needs to be done at the executive level—and especially at the board level. Boards are in dire need of sound and effective ways to ensure they are doing the right things to promote a high-level quality of care in their organizations. The California HealthCare Foundation sponsored a roundtable for California hospitals and health systems in early December 2005 that focused specifically on mobilizing healthcare organizations for quality. The roundtable, organized and conducted by The Governance Institute and endorsed by the California Hospital Association, called on representatives from California hospitals and health systems to work collectively to identify obstacles and solutions to raising the bar in quality and patient safety.