A framework for the continual improvement of health care: building and applying professional and improvement knowledge to test changes in daily work

Jt Comm J Qual Improv. 1993 Oct;19(10):424-47; discussion 448-52. doi: 10.1016/s1070-3241(16)30025-6.


We seem to lack a well-defined, comprehensive, and shared understanding of what is required for the continual improvement of health care--at the organizational and the industry levels. This article presents a framework that defines the new body of knowledge which, when joined with the professional knowledge of health care workers, can make continual improvement possible; and gives requirements for building and applying this knowledge to bring about improvement in health care organizations.

MeSH terms

  • Clinical Competence
  • Consumer Behavior
  • Group Processes
  • Health Knowledge, Attitudes, Practice*
  • Health Personnel / organization & administration
  • Health Services / standards*
  • Health Services Administration
  • Hospitals, Community / organization & administration
  • Hospitals, Community / standards
  • Leadership
  • Models, Organizational
  • Research Design
  • Social Values
  • Total Quality Management / organization & administration*
  • United States