The imperative for quality: a call for action to medical schools and teaching hospitals.

Patient safety and quality improvement are critical clinical and research endeavors supported by the federal government, accrediting bodies, regulatory agencies, and patient-advocacy groups. The Boston-based Institute for Healthcare Improvement has led in educating physicians, nurses, and other health professionals to improve the effectiveness and efficiency of their delivery systems. Recently, academic medical institutions have come together to improve patient outcomes by participating in the institute's IMPACT network. Each participating institution works in one or more of five improvement domains: patient safety, intensive care, patient flow, office practice, and workforce development. In addition, the chief executive officer of each participating organization focuses on leadership. The infrastructure for raising the bar of performance is improving at medical schools and teaching hospitals in this country. Important trends include interdisciplinary centers of excellence, improved faculty practice plan governance and management, leadership recruitment and development, and a commitment to quality as a high educational priority at a number of medical schools. Quality improvement efforts are intellectual activities that are consistent with the values of academic medicine and discovery. Academic medical centers are well positioned to lead the way in the improvement of quality of care. As institutions entrusted with the education of future health professionals and charged with developing new knowledge, the authors call for a complete commitment to the highest level of quality in patient care.