A survey of Canadian health care organizations indicates growing interest in the philosophy and methods of continuous quality improvement (CQI). Most organizations are still in the early stages of learning and applying CQI. Although CEOs have been learning about CQI and have been participating in quality councils, they are less involved in using and teaching CQI techniques. Major obstacles reported in developing quality improvement are lack of time, limited resources, lack of training, and pressures to deal with other changes. Only a few organizations question the value of developing quality improvement, and many who have not yet adopted CQI say they intend to do so.