Improving patient safety.

For well over a decade, I have participated in an effort to develop and encourage a new level of investment in quality improvement in American health care. This has been in many ways a very gratifying process, but it has also been frustrating. Despite many decades of research and literally thousands of journal papers documenting how much improvement is scientifically possible in health care, neither the professionals nor the public have become truly energized to tackle the challenge. Issues in quality of health care have remained largely background issues; few people have regarded quality as a central problem. (Fall 2000)