Continuous quality improvement (CQI) is a system of management that permits individuals to develop an organized approach to improvement. The fundamental tenets of CQI are applicable at the bedside and in the training of residents because they permit the development of a consistent approach to clinical variability and uncertainty. When the principles of CQI are applied to the daily practice of medicine, they not only enhance the educational process but also provide a framework for the continuing quest for knowledge. In that context, these principles can provide a continuing stimulus and challenge to physicians and can enhance the patient-physician relationship that lies at the core of any effort to integrate CQI into patient care.