Routine monitoring of the quality of care has become an important focus throughout the mental health system. Providers of care, payers, managed care organizations, regulators, and accrediting bodies have each implemented their own measures and specifications. The resulting heterogeneity among measures has increased the burden on providers, limited the comparability of findings, and hindered efforts to focus limited resources on development of the most promising measures. In this issue, Richard C. Hermann, M.D., M.S., and R. Heather Palmer, M.B.,B.Ch., S.M., acknowledge that selecting a core set of measures is "an ambitious undertaking." They describe the desirable attributes of such measures and the ways in which stakeholders' different perspectives and priorities have prevented them from reaching a consensus. The authors present a framework that stakeholders can use to understand and integrate the underlying dimensions and tensions of the selection process and take steps toward consensus (see page 281).