Measurement: Process and Outcome Indicators
Methods of Quality Improvement
Things Quality Improvement is NOT
Summative Experience


The distinction between QI and research is an important one. There is a spectrum, and it can be blurry sometimes, but there are some key points (with legal implications!).


  1. Intent is to improve current practice. For internal use only.
  2. By definition, the data is confidential.
  3. Action is within existing standards of care.
  4. Institutional Review Board (IRB) approval is not necessary.


  1. Intended to create generalized knowledge.
  2. Desire to publish or present.
  3. Testing new methods.
  4. Needs IRB approval!
    (Click here to go to the Duke IRB website for more information)

Check your understanding

Is IRB approval needed for these projects?

Testing use of a well-known automated vital signs machine to see if it improves flow of patients in a busy clinic.
Testing use of innovative new vital signs equipment to see if it improves the flow of patients in a busy clinic.
Tracking average Hemoglobin A1c levels to assess a practice's performance on diabetes care.
Presenting at an academic meeting about the impact of QI efforts on average Hemoglobin A1c levels.
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