This document discusses quality in the healthcare systems of Germany and the United States. It defines healthcare quality and how it is measured, including through quality indicators, checklists, and random checks. Quality assurance organizations and approaches are described and compared for both countries. The document identifies areas for improvement in both systems, such as increasing patient-centeredness and transparency in Germany, and reducing variation and overuse/underuse of services in the US. In conclusion, the document states that quality assurance requires collaboration across healthcare stakeholders and that high structural quality is important for improving outcomes and processes.