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Previous Volume 356:951-953 March 1, 2007 Number 9 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.

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In this issue of the Journal, Landon and colleagues report on a Herculean undertaking — a study of quality-improvement interventions conducted at 44 community health centers.¹ This study showed a modest improvement in some process measures and no improvement in intermediate or end-stage outcomes — results that are similar to those of most previous large-scale quality-improvement initiatives. As the authors correctly note, improved processes may not be accompanied by discernible improvements in outcomes for several reasons. A particularly important problem is that the majority of Health Plan Employer Data and Information Set–style performance measures used to guide most large-scale quality-improvement . . . [Full Text of this Article]

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From the VA Ann Arbor Health Services Research and Development Center of Excellence and the Schools of Medicine and Public Health, University of Michigan — both in Ann Arbor.

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