A report card on continuous quality improvement

Milbank Q. 1998;76(4):625-48, 511. doi: 10.1111/1468-0009.00108.


Efforts to incorporate the principles of continuous quality improvement (CQI) into health care have been underway for about ten years. In order to understand the lessons of this decade of experience, senior organizational leaders and experts in the field of health care were interviewed. This select group agreed that there have been concrete accomplishments: the tactic of assigning blame for mistakes to individuals is gradually giving way to an emphasis on detecting problems with process; there is a new focus on the health care customer; and many valuable projects have been inaugurated. Nevertheless, the interviews underlined the reality that the movement has not yet made a sizable impact on the U.S. health care system. Until there is a profound, organization-wide recognition of the need for change, universal commitment to CQI principles will not be achieved.

Publication types

  • Review

MeSH terms

  • Attitude of Health Personnel*
  • Delivery of Health Care / standards
  • Delivery of Health Care / trends
  • Evaluation Studies as Topic
  • Humans
  • Interviews as Topic
  • Outcome and Process Assessment, Health Care
  • Quality Indicators, Health Care
  • Quality of Health Care / statistics & numerical data
  • Quality of Health Care / trends*
  • Total Quality Management / statistics & numerical data*
  • United States