Quality improvement (QI) projects have 2 fundamental aims: (1) to eliminate unnecessary and undesirable variation in medical service delivery and (2) to increase the adherence of medical practice to widely accepted standards of care. Quality improvement projects are generally undertaken with the guidance of a study group composed of representatives from stakeholders involved in the process and are based on major consensus guidelines. True QI projects target processes of cares and not outcomes, although processes of care strongly linked with favorable outcomes are preferred. A process of care can be defined as a medical decision or a clinical intervention that is performed for a patient or group of patients in the course of managing or preventing a disease. This decision or intervention is usually made at the site of care. Thus, decreasing length of stay, which was one of the examples by Lo and Groman,1 alters an outcome, not a process of care, and should not be considered a QI project. On the other hand, increasing the use of β-blockers in the post–acute myocardial infarction patient, which has been strongly linked with decreased mortality, is an example of an excellent QI project. Quality improvement projects do not attempt to test new or novel drugs or devices. They do not aim to save money for patients, hospitals, or anyone else. It may sometimes be true, however, that by improving a process of care, a by-product of the QI project may be a cost savings or a shorter length of stay.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and
Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early
dhildhood mortality and growth failure data and their association with maternal
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 3
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Users' Guides to the Medical Literature
Chapter e23. How to Use an Article About Quality Improvement
All results at
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.