FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 357:608-613 August 9, 2007 Number 6 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF PDA Full Text Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

The past 7 years have seen unprecedented interest in patient safety and the quality of health care.^1,2,3 As physicians whose careers are focused on improving quality and safety, we have welcomed this change. However, we have also witnessed recent initiatives that emphasize dissemination of innovative but unproven strategies, an approach that runs counter to the principle of following the evidence⁴ in selecting interventions that meet quality and safety goals, as well as the idea that interventions should be tailored to local needs and resources.⁵ These principles have been used as safeguards in helping us pursue practices that have clear benefits . . . [Full Text of this Article]

Argument 1: We Cannot Wait

Argument 2: Any Effort to Improve Is Better Than the Current State of Affairs

Argument 3: Emulating Successful Organizations Can Speed Improvement

Argument 4: The Effectiveness of Some Quality-Improvement Strategies Is Obvious

Argument 5: Promising but Unproven Strategies Can Catalyze Innovation

Argument 6: The Framework of Evidence-Based Medicine Does Not Apply to Quality Improvement

Argument 7: Developing Evidence in Quality Improvement Is Too Costly

Conclusions

Source Information

From the University of California, San Francisco, Department of Medicine, San Francisco (A.D.A., C.S.L.); San Francisco Veterans Affairs Medical Center, San Francisco (C.S.L.); and Ottawa Health Research Institute, Ottawa (K.G.S.).

This article has been cited by other articles:

• Tu, J. V., Donovan, L. R., Lee, D. S., Wang, J. T., Austin, P. C., Alter, D. A., Ko, D. T. (2009). Effectiveness of Public Report Cards for Improving the Quality of Cardiac Care: The EFFECT Study: A Randomized Trial. JAMA 0: 2009.1731-8 [Abstract] [Full Text]  
• Maisels, M. J., Bhutani, V. K., Bogen, D., Newman, T. B., Stark, A. R., Watchko, J. F. (2009). Hyperbilirubinemia in the Newborn Infant >=35 Weeks' Gestation: An Update With Clarifications. Pediatrics 124: 1193-1198 [Full Text]  
• Newman, T. B. (2009). Universal Bilirubin Screening, Guidelines, and Evidence. Pediatrics 124: 1199-1202 [Full Text]  
• Goldberg, A. E., Harnish, J. L., Stegienko, S., Urbach, D. R. (2009). Attitudes of Patients and Care Providers Toward a Surgical Site Marking Policy. SURG INNOV 16: 249-257 [Abstract]  
• Kahn, R., Anderson, J. E. (2009). Improving Diabetes Care: The Model for Health Care Reform. Diabetes Care 32: 1115-1118 [Full Text]  
• Kelsall, D. (2009). Doit-on continuer de priver les residents de sommeil?. CMAJ 180: E59-E59 [Full Text]  
• Kelsall, D. (2009). Must we keep depriving residents of sleep?. CMAJ 180: 1087-1087 [Full Text]  
• Ting, H. H., Shojania, K. G., Montori, V. M., Bradley, E. H. (2009). Quality Improvement: Science and Action. Circulation 119: 1962-1974 [Full Text]  
• Shojania, K. G., Levinson, W. (2009). Clinicians in Quality Improvement: A New Career Pathway in Academic Medicine. JAMA 301: 766-768 [Full Text]  
• Pronovost, P. J., Goeschel, C. A., Marsteller, J. A., Sexton, J. B., Pham, J. C., Berenholtz, S. M. (2009). Framework for Patient Safety Research and Improvement. Circulation 119: 330-337 [Full Text]  
• Durthaler, J. M., Ernst, F. R., Johnston, J. A. (2009). Managing severe sepsis: A national survey of current practices. Am J Health Syst Pharm 66: 45-53 [Abstract] [Full Text]  
• Howell, E., Bessman, E., Kravet, S., Kolodner, K., Marshall, R., Wright, S. (2008). Active Bed Management by Hospitalists and Emergency Department Throughput. ANN INTERN MED 149: 804-810 [Abstract] [Full Text]  
• Henkind, S. J., Sinnett, J. C. (2008). Patient Care, Square-Rigger Sailing, and Safety. JAMA 300: 1691-1693 [Full Text]  
• Thomson, R G, Moss, F M (2008). QIR and SQUIRE: continuum of reporting guidelines for scholarly reports in healthcare improvement. Qual Saf Health Care 17: i10-i12 [Full Text]  
• Ogrinc, G, Mooney, S E, Estrada, C, Foster, T, Goldmann, D, Hall, L W, Huizinga, M M, Liu, S K, Mills, P, Neily, J, Nelson, W, Pronovost, P J, Provost, L, Rubenstein, L V, Speroff, T, Splaine, M, Thomson, R, Tomolo, A M, Watts, B (2008). The SQUIRE (Standards for QUality Improvement Reporting Excellence) guidelines for quality improvement reporting: explanation and elaboration. Qual Saf Health Care 17: i13-i32 [Abstract] [Full Text]  
• Shojania, K. G. MD, Forster, A. J. MD MSc (2008). Hospital mortality: when failure is not a good measure of success. CMAJ 179: 153-157 [Full Text]  
• Mehrotra, A., Keehl-Markowitz, L., Ayanian, J. Z. (2008). Implementing Open-Access Scheduling of Visits in Primary Care Practices: A Cautionary Tale. ANN INTERN MED 148: 915-922 [Abstract] [Full Text]  
• Landefeld, C S., Shojania, K. G, Auerbach, A. D (2008). Should we use large scale healthcare interventions without clear evidence that benefits outweigh costs and harms? No. BMJ 336: 1277-1277 [Full Text]  
• Bever, C. T., Holloway, R. G., Iverson, D. J., Dubinsky, R. M., Richardson, R. M., Sheffield, J. K., Wang, D. Z., Franklin, G. M., Miyasaki, J. M., Tonn, S. T., Stevens, J. C. (2008). Invited Article: Neurology and quality improvement: An introduction. Neurology 70: 1636-1640 [Full Text]  
• Heath, I. (2008). Never had it so good?. BMJ 336: 950-951 [Full Text]  
• Berwick, D. M. (2008). The Science of Improvement. JAMA 299: 1182-1184 [Full Text]  
• Meropol, S. B. (2008). Children and the Quality of Ambulatory Care. NEJM 358: 532-533 [Full Text]  
• Pronovost, P. J., Miller, M., Wachter, R. M. (2007). The GAAP in Quality Measurement and Reporting. JAMA 298: 1800-1802 [Full Text]