July 2010 - September 2012

Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies


Principal Investigator
Senior Fellow
  • Professor, Medicine (CHP/PCOR)
default people 100x120
Robert M. Wachter
default people 100x120
Kaveh G. Shojania

Project Goal
To create and apply a methodology for the review of quality improvement implementation strategies -- approaches to closing the "quality gap" between ideal and actual care -- in national priority areas identified recently by the Institute of Medicine (IOM). These priority areas were selected by the IOM based on the notion that most quality problems in health care arise not from a lack of effective clinical practices, but rather from inadequate delivery strategies for implementing these practices.

The EPC will produce a series of four evidence-based reports covering quality improvement implementation strategies addressing 16 IOM priority areas.


  • Consult with a wide range of experts and stakeholders to help develop an effective approach to identifying a wide range of quality improvement implementation strategies.
  • Identify and describe major systematic review studies about quality improvement implementation strategies.
  • Develop an analytic framework to explain ways in which quality improvement implementation strategies may influence health outcomes.
  • Conduct a systematic review of quality improvement strategies directed at reducing the gap between ideal and actual care for each selected topic.