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International Journal for Quality in Health Care Advance Access originally published online on November 16, 2006
International Journal for Quality in Health Care 2007 19(1):8-10; doi:10.1093/intqhc/mzl059
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International Journal for Quality in Health Care vol. 19 no. 1 © The Author 2006. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved

The challenge of explaining why quality improvement has not done better

Robert L. Kane and Gordon Mosser

University of Minnesota, School of Public Health, MMC 197, Minneapolis, MN, USA

Keywords: health care organizations, health care safety, quality improvement

Address reprint requests to Robert L. Kane, University of Minnesota, School of Public Health, Minneapolis, MN, USA. E-mail: kanex001@umn.edu

Accepted for publication October 12, 2006.

The first 150 words of the full text of this article appear below.

Success has many fathers, but failure is an orphan.

(John F. Kennedy)

It is always easier to suggest reasons why something failed than succeeded. The frequently expressed concerns about quality of health care make it a fitting topic for examination [1–3]. Many preach the doctrine of continuous improvement, arguing that the system is at fault not the individual [4–7]. Whereas some bemoan the lack of a business case for quality in health care [8], others propose creating environments that will encourage and reward better quality [9–11]. There is a litany of problems in introducing quality improvement in health care [12–15]. Report cards and pay for performance can certainly yield perverse results [16].

The analysis by T. Katz-Navon et al. in this issue puts forth three reasons why efforts to improve quality have not . . . [Full Text of this Article]


   Physicians as pilots
 

   Mixed messages
 

   Open organizations
 

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