Methodological issues in performance improvement in integrated systems

This article presents an overview of processes necessary for effective performance improvement (PI) projects and includes a discussion of methodological issues that affect the quality of PI projects. Issues related to project design, project purpose, selection of a representative population for the project, and issues of sampling are presented. Data collection methods and instruments are analyzed and issues related to connecting the problem, the intervention, and the outcome are described. The final sections address strategies related to data analysis procedures and interpretation.