From 1990–2008, URC and our non-profit affiliate, the Center for Human Services, provided global leadership to the USAID-funded Quality Assurance Project (QAP) I,II, and III. The project, which operated in 37 developing and middle-income countries, worked within Laos to provide technical assistance and conducted operations research on health care quality improvement (QI). This work helped raise awareness in countries and internationally that quality improvement is an essential component of health systems strengthening and that quality standards and QI capacity development are vital to the development of health care systems in even the most resource-constrained countries. The most significant element of QAP’s legacy is the project’s adaptation and widespread application of the Institute for Healthcare Improvement collaborative model in USAID-assisted countries.