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Our goal as health care professionals is to provide patients with the best care available.
One important challenge is the slow translation of research evidence into clinical practice. It is essential that such "knowledge translation" is efficient and timely to ensure that patients receive the most effective therapies and achieve improved outcomes. 1 Currently, the gap between publication of clinical research findings and their implementation into routine clinical practice is substantial2 and leads to suboptimal health care delivery.3 Alan Jette, PT, PhD, FAPTA, addressed this issue in the 43rd Mary McMillan Lecture, in which he shared his vision for the physical therapy profession to be a leader in implementing evidence-based strategies for health promotion and treatment interventions.4
One approach to facilitating the translation of research into clinical practice is the use of systematic quality improvement (QI) processes. 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.
When reviewing the results of QI projects, readers must be aware of the risk of bias.11 Therefore, to ensure patient safety, it is essential that QI projects are rigorously designed, conducted, and evaluated.7,12,13 Without this rigor, QI reports may potentially result in patient harm, poor use of limited resources,...