Evidence-based quality improvement: the state of the science.
Routine practice fails to incorporate research evidence in a timely and reliable fashion. Many quality improvement (QI) efforts aim to close these gaps between clinical research and practice. However, in sharp contrast to the paradigm of evidence-based medicine, these efforts often proceed on the basis of intuition and anecdotal accounts of successful strategies for changing provider behavior or achieving organizational change. We review problems with current approaches to QI research and outline the steps required to make QI efforts based as much on evidence as the practices they seek to implement.
Shojania
Kaveh G
KG
Ottawa Health Research Institute (OHRI), Ontario. kshojania@ohri.ca
Grimshaw
Jeremy M
JM
D019090:Case Management; D019468:Disease Management; D019317:Evidence-Based Medicine; D017408:Guidelines as Topic; D006801:Humans; D017749:Total Quality Management; D014481:United States