Assessing Quality Improvement in Health Care

Theory for Practice

Gaps in the role of theory to enhance the practice of QI research are explored in this research.

The U.S. health system has pervasive deficits in quality including disparities by race, ethnicity, and income. Yet, the overarching aims, as articulated by Donald Berwick and colleagues and adopted by the federal government, are better care, better health, and lower cost. To do that for child health care, the Centers for Medicare & Medicaid Services and the Agency for Healthcare Research and Quality have established Seven Centers of Excellence and two state Medicaid programs as part of the Pediatric Quality Measures Program.

The article identifies gaps in the current theory and practice of quality improvement (QI) research, suggests approaches for closing those gaps, and how to build a theory of applied QI to help generalize findings from evaluations and help the nation meet its articulated goals.

“Quality and QI research require the collaboration of excellent listeners, sophisticated methodologists, and conceptual and analytic thinkers, all coming together with open minds that are informed but not bound by theory,” the authors write.