BMJ 2003;326:759-761 ( 5 April )

Education and debate

Improving the quality of health care

Using research to inform quality programmes

This is the first of three articles on research to improve the quality of health care

John Øvretveit, director of research ^a, David Gustafson, Robert Ratner professor of industrial engineering and preventive medicine ^b. 

^a Medical Management Centre, Karolinska Institute, Stockholm Sweden S-40242, ^b University of Wisconsin, 610 Walnut Street, University of Wisconsin, Madison WI 53705, USA

Correspondence to: J Øvretveit jovret@aol.com

The first 150 words of the full text of this article appear below.

Quality programmes consume more resources than any treatment and have potentially greater consequences for patient safety and other clinical outcomes. So why do we know so little about whether they are effective?

Health resources that could be used for clinical care are increasingly being devoted to large scale programmes to improve the quality of health care. Examples include national quality initiatives, hospital programmes, and quality accreditation, assessment, and review processes. However, little research has been done into their effectiveness or the conditions needed to implement quality programmes successfully. This is partly because the programmes are difficult to evaluate: they change over time, are applied to changing organisations, and need to be assessed from different perspectives. However, research can produce valid and useful knowledge about how to make such programmes work. We describe what research has shown us so far and highlight how better information can be obtained.

Summary points Quality programmes are large scale interventions to improve health care Little research is available to show if they work or are cost effective Such research is difficult because the programmes involve dynamic organisations and change over time Research can identify the factors needed for successful implementation

	What is a quality programme?

Quality programmes are . . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

Underwrites what we already knew

Iņigo Romon-Alonso
bmj.com, 4 Apr 2003 [Full text]

Large scale quality programs can improve care

Brian T Collopy, et al.
bmj.com, 7 Apr 2003 [Full text]

Cochrane Effective Practice and Organisation of Care group

Laura M McAuley, et al.
bmj.com, 29 Apr 2003 [Full text]

Further Support

Brian W Johnston
bmj.com, 9 May 2003 [Full text]

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