Improving Research and Evaluation Around Continuous Quality Improvement in Health Care

Over the past fifteen years, the Robert Wood Johnson Foundation (RWJF) has encountered unique challenges while trying to evaluate the effectiveness of programs that involve continuous quality improvement (CQI) as a strategy for progress. Specifically:

  • When we try an initiative that uses the theory and methods of CQI to improve performance at some level of health care organization, how do we know that the initiative has worked?
  • How, and what, do we learn from these initiatives?  How do we know whether a similar initiative will work in other organizations? 
  • How do we build the science of improvement in health care settings?  
  • If we are able to produce evidence that CQI improves care, how do we institutionalize the practice and study of such initiatives?

This report discusses the challenges of evaluating CQI, recommendations to address these challenges, and existing gaps in the research.