The proliferation of program management coupled with the Introduction of the Regulated Health Professions Act, prompted many healthcare organizations in Ontario to introduce professional practice models. In addition, the Magnet Hospitals research (Kramer and Schmalenberg 1988) identified the existence of a professional practice model as a key element for recruitment and retention of professional staff. Professional practice models were introduced to address issues of accountability, identity and overlapping scopes of practice as experienced by healthcare professionals and organizations across the continuum of care. The authors of this paper describe exploratory work done through the Professional Practice Network of Ontario to identify the essential elements of the "ideal" professional practice structure, key areas of challenge and strategies for adapting these elements into an organization. The paper presents a list of 16 essential elements of an ideal professional practice structure with a further discussion on four key areas consistently identified as areas of challenge. This paper is intended to report, not the findings of a formal research study, but rather the result of facilitated dialogue among professional practice leaders in Ontario. The information will be of interest to healthcare organizations across the continuum of care and to professional associations and academic institutions, as we all address the challenges of creating a quality work environment that supports and fosters excellence in professional practice.