Since its inception in 2003, and the signing of the Canada Health Accord in 2004, the Council of the Federation has continued to work on behalf of all Canadians to improve our health care system. [...] With the end of the Health Accord, the Council of the Federation has taken on even greater significance for the future of our health care system and nurses recognize the importance of your efforts and want to contribute our energy and expertise. [...] The CFNU strongly recommends that to accomplish a key objective of Canada’s Premiers – a safe, accessible and sustainable health care system for all Canadians – all decision makers must include the front line of health care with the meaningful representation and engagement of nurses unions and employers’ representatives as an integral part of the Council of Federation health care innovation consul [...] Under the banner of the Council of the Federation, provincial and territorial governments are currently working to redesign and transform the health system to achieve the triple aim of: better health, better care, and better value. [...] As cited by the Canadian Foundation for Healthcare Improvement4, the Council of the Federation offered the following definition of appropriateness: In the context of health care, appropriateness is the proper or correct use of health services, products and resources.