These deficiencies in quality of care represent neither the failure of professional compassion nor necessarily a lack of resources (Institute of Medicine 2001). Rather, they result from gaps in knowledge, inappropriate applications of available technology (Murray and Frenk 2000), or the inability of organizations to change (Berwick 1989). Local health care systems may have failed to align practitioner incentives and objectives, to measure clinical practice, or to link quality improvement to better health outcomes.
Increasing evidence, much of it developed since the mid 1990s, shows that quality can be improved rapidly. However, to improve clinical practice—and thus quality of care—quality must be defined and measured, and appropriate steps must be taken (Silimper and others 2002). This chapter highlights approaches to improving clinical practice and quality of care that take place over months instead of years. Indeed, better quality can improve health much more rapidly than can other drivers of health, such as economic growth, educational advancement, or new technology. Hope this helps
