This article presents a framework for integrating equity considerations into health care quality improvement (QI). Through a case study of disparities in nephrology care, the authors contrast traditional and equity-focused QI approaches. It outlines critical components of equity-focused QI including identifying social and structural root causes, disaggregating data across demographic dimensions, designing tailored interventions based on population needs, ensuring diverse team composition with meaningful community representation, and measuring impact through stratified quantitative metrics and qualitative assessment. We argue that achieving health care excellence requires transforming QI practice to treat equity as an essential dimension of quality.