Can a collection of activities be categorized as “quality improvement”? Is it research? Practice? Do we need to obtain informed consent from patients if we are soliciting their feedback to change our practices? It started me puzzling on the evolution of our use of language in the field.

The words we attach to ideas and experiences shape our thinking about them.¹ The terms “quality improvement”, “quality improvement project”, “QI tools”, “QI methods”, a “quality improvement activity” and many other examples of using the words “quality” and “improvement” in a noun or adjectival form have helped people to name and understand what was new about some new activities and energies to change and improve health care. I wonder if the way we use these words is changing?

The words “quality” and “improvement” are not new. From the early 14th century Latin “quālis” and the later French “qualitie”, our modern …