Improving quality of health-care requires a systematic approach at many different levels within a health system. The levels range from the interactions between individual patient-health provider to the international stage. The provision of care within and between each level needs to be systematically organised if the quality of our health-care is to improve. There is a need to develop a systematic approach to the multiple systems within health care. An organisational structure similar to the Cochrane Collaboration may provide the mechanism to better coordinate all our efforts to improve health-care quality.