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Invited Commentary
April 10, 2017

Communicating Context in Quality Improvement Reports

Author Affiliations
  • 1Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco
  • 2Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, San Francisco
JAMA Intern Med. Published online April 10, 2017. doi:10.1001/jamainternmed.2017.0461

The study by Demb and colleagues1 reports on the positive results of an intervention strategy to reduce excess radiation exposure across 5 academic medical centers associated with the University of California. Leading up to this intervention, a variety of initiatives and recommendations had been implemented across these institutions to help guide institutions in this effort. However, significant variation between institutions had remained, in part because single institutions found it difficult to determine the “right” dose of radiation that balances diagnostic accuracy and minimizes radiation exposure for the patient. By creating a venue for leaders from the 5 institutions to collectively define and standardize best practices, with allowance for flexibility within each institution to create an optimal set of tactics best suited for each institution, the study team1 hypothesized that greater reductions (and less variation) in radiation exposure could be achieved. And they were right.

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