The role of regulation in quality improvement.

Many new methods for measuring the quality of health care have been devised since 1970. For the past ten years, the health care field has been struggling to integrate industrial models into its quality improvement systems. In order to judge whether regulation has evolved in tandem with these developments, three critical questions are examined: Is regulation improving the quality of health care? Are regulators integrating the tools of quality research into their oversight activities? Is there a way to combine continuous quality improvement (CQI) and modern methods of quality measurement into a new regulatory format? An exploration of these questions produces relatively little evidence that regulation has moved in the recommended direction, although there are some encouraging signs that regulators are becoming more responsive to the issues.