Without the denominator where is the quality improvement paradigm in the nation's health care reform?

This paper will argue that there is room for improvement in the quality of health care delivered in the United States. A quality improvement paradigm requires an assessment, inventory and prioritization of areas for improvement. It further nurtures the imperative of process improvement for the achievement of a targeted outcome. The dual obligations of reduction in outcome variability, and resource management, provide an exciting milieu for the integration of clinical practice, the numerator, with population based medicine, the denominator.