Quality improvement: from theory to practice

Paul Ellwood, talking about the American health care delivery system, said: "When you're spending half a trillion dollars, you ought to know what works." Given the fiscal constraints facing American health care, and given the concerns of quality erosion and the emerging technologies with their associated costs, we'd better heed his advice. We cannot beg the cost issues surrounding us. There is a cost to poor quality and we cannot afford it anymore.