to promote having informed patients, the challenge remains doing so effectively, which requires efforts to promote transparency both in terms of costs and quality outcomes.

Creating a value proposition for research on quality improvement is somewhat different than for quality improvement itself and involves a number of issues. Recognition that data give weight to health care leaders’ desire to champion and implement quality improvement was an important point in the discussion. Becoming better at translating the research available for uptake is urgently needed because research is done for a purpose, not merely for its own sake. Priorities for quality improvement research must be set, Leviton said, because they allow society to effectively allocate resources. Having priorities would also help to articulate the potential value of quality improvement, as has occurred successfully with cancer research (number of lives saved) and smoking cessation research (the societal effect of quit rates). Finally, data currently being gathered are not tracking outcomes that matter. Data should be collected over time, which could be facilitated by electronic health records and could have beneficial effects on improving patient education and producing health care reform.


Effective intraorganizational quality improvement gains must be created within an environment where quality is a top priority and not just a short-term project, O’Neill said, reporting for the breakout group that explored that topic. Organizations successfully improving quality do not have an attitude of “we’re great at everything we do,” but instead think of ways to continuously improve. Quality improvement and safety should be automatic within an organization to promote change.

A number of common themes arose from this breakout group. First, there is an essential need for transparency, as found in the value proposition group. Management and top leadership must accept responsibility for everything that goes wrong within an organization because doing so gives those people actually making mistakes permission to identify their mistakes. People must not be punished, blamed, or criticized for their mistakes so that lessons can be learned to prevent the same mistakes from recurring.

Second, having clear objectives is critical to make progress both within and across organizations. Clarity of objectives allows people

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