Article Text

Download PDFPDF

What is “quality improvement” and how can it transform healthcare?
  1. Paul B Batalden1,
  2. Frank Davidoff2
  1. 1Center for Evaluative Sciences, Dartmouth Medical School, Hanover, New Hampshire, USA
  2. 2Institute for Healthcare Improvement, Cambridge, Massachusetts, USA
  1. Correspondence to:
 Dr P B Batalden
 Center for Evaluative Sciences, Dartmouth Medical School, Hanover, NH 03755, USA

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Transformation of healthcare—quality improvement

Many in healthcare today are interested in defining “quality improvement”. We propose defining it as the combined and unceasing efforts of everyone—healthcare professionals, patients and their families, researchers, payers, planners and educators—to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning; fig 1). This definition arises from our conviction that healthcare will not realise its full potential unless change making becomes an intrinsic part of everyone’s job, every day, in all parts of the system. Defined in this way, improvement involves a substantial shift in our idea of the work of healthcare, a challenging task that can benefit from the use of a wide variety of tools and methods (table 1).

View this table:
Table 1

 Illustrative tools and methods in improvement

Figure 1

 Linked aims of improvement.

Although all improvement involves change, not all changes are improvement. If healthcare is going to benefit fully from the science of disease biology, we need to be sure that the changes we make …

View Full Text


  • Competing interests: None declared.