Quality performance improves when measures are treated as engineered systems rather than isolated rates to chase. This session brings together the 7 Layer Quality OSI model and proven FQHC HEDIS improvement practices to show how teams can systematically diagnose where measures break down and design targeted, sustainable fixes. Speakers will demonstrate how to map UDS and HEDIS measures across data, workflow, clinical decision making, care coordination, and patient activation layers, then translate specifications into reliable standard work supported by ownership, PDSA cycles, and closed loop follow up. Attendees will leave with practical frameworks and tools to align quality, informatics, and operations teams, operationalize equity through disaggregated data, and build durable improvement systems that perform across UDS, HEDIS, and FQHC reporting portfolios.