Content area
Abstract
Quality improvement attempts to change clinician behavior and, through those changes, lead to more consistent, appropriate, and efficient application of established clinical interventions, resulting in improved care and patient outcomes.5 Quality improvement is an intrinsic part of good clinical practice and is designed to bring about immediate improvements in health care in local settings.6 Quality improvement assumes that quality and safety are characteristics of health care systems, and many QI activities involve groups of clinicians, managers, and staffcooperating to improve procedures and practices.6 Quality improvement differs from human subject research in that the latter identifies new, effective therapies, whereas QI interventions are designed to enhance the realworld implementation of proven therapies, such as implementing an evidence-based practice guideline.6 To increase the reliable use of clinical research, not only does practitioner behavior need to change, but changes must occur in the culture of health care teams and organizations.7 Two very successful QI projects8-10 have used a 4-step model7: (1) summarizing the evidence; (2) identifying barriers; (3) establishing performance measures; and (4) ensuring patients receive the intervention by engaging the team, educating the team, executing the intervention, and evaluating the outcomes.