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Assessing the Impact of Continuous Quality Improvement on Clinical Practice: What It Will Take to Accelerate Progress

Open access
Shortell, Stephen M., Bennett, Charles L., Byck, Gayle R.·1998·The Milbank Quarterly

Abstract

The literature on continuous quality improvement (CQI) has produced some evidence, based on nonrandomized studies, that its clinical application can improve outcomes of care while reducing costs. Its effectiveness is enhanced by a nucleus of physician involvement, individual practitioner feedback, and a supportive organizational culture. The few randomized studies, however, suggest no impact of CQI on clinical outcomes and no evidence to date of organization‐wide improvement in clinical performance. Further, most studies address misuse issues and avoid examining overuse or underuse of services. The clinical application of CQI is more likely to have a pervasive impact when it takes place within a supportive regulatory and competitive environment, when it is aligned with financial incentives, and when it is under the direction of an organizational leadership that is committed to integrating all aspects of the work.

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Metadata

Authors
Shortell, S. M., Bennett, C. L., & Byck, G. R.
Venue
The Milbank Quarterly
Publisher
Wiley
Published
1998-12
Volume
76
Issue
4
Pages
593-624
ISSN
  • 0887-378X (ISSN-L)
  • 1468-0009
OpenAlex
W2012285058
Cited by
639
References
0
FWCI
71.50
Type
journal article
Language
en
Open access
bronze

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.