97 ABSTRACT When a vision is shared, so too can be the agenda required to achieve it – this quote from Wedge and Currie (2016: 67) offers a key lesson from this issue of Healthcare Papers, which presents the experiences of a chronic disease quality improvement collaborative (QIC) in Atlantic Canada. The Atlantic Healthcare Collaboration for Innovation and Improvement in Chronic Disease (AHC) hosted its last workshop in June 2014. Key findings from the summative evaluation, undertaken by the Canadian Foundation for Healthcare Improvement (CFHI) in fall–winter 2014–15, are reported in the lead paper of this issue (Verma et al.), followed by commentaries from some of those who were involved (Phillips et al.; Vallis 2016; Wedge and Currie 2016) as well as experts in chronic care and improvement capability (Wagner 2016 and Delgado 2016, respectively). As this final paper reveals, time is often an important factor in realizing improvement – in the time period since the lead paper was written, for example, the number of teams progressing to implementation and evaluation has doubled. This closing paper highlights team progress and summarizes our reflections on creating improvement capacity, leading large-scale change and partnering with patients and families to get there. All of these are critically important in shaping the kind of health and care Canadians need and expect. A Last Word on Collaborating for Lasting Change THE AUTHORS RESPOND Jennifer Y. Verma, Stephen Samis, Jean-Louis Denis, Maureen O’Neil and François Champagne u