Is money spent on quality improvement better spent on clinical care? — No

William B Runciman
Med J Aust 2011; 194 (12): . || doi: 10.5694/j.1326-5377.2011.tb03148.x
Published online: 20 June 2011

Professor Bill Runciman believes much clinical care is inappropriate, and QI can be effective

NOThe evidence that more care does not mean better care is overwhelming, and the scope for savings . . . is huge.1

  • School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, SA.


Competing interests:

None identified.

  • 1. Godlee F. Tackling practice variation [Editor’s choice]. BMJ 2011; 342: d1080.
  • 2. McGlynn EA, Asch SM, Adams J, et al. The quality of health delivered to adults in the United States. N Engl J Med 2003; 348: 2635-2645.
  • 3. Runciman WB, Merry A, Walton M. Safety and ethics in healthcare; a guide to getting it right. Aldershot, UK: Ashgate, 2007.
  • 4. Sutherland JM, Fisher ES, Skinner JS. Getting past denial — the high cost of health care in the United States. N Engl J Med 2009; 361: 1227-1230.
  • 5. Elshaug AG, Moss JR, Littlejohns P, et al. Identifying existing health care services that do not provide value for money. Med J Aust 2009; 190: 269-273. <MJA full text>
  • 6. Pronovost PJ, Goeschel CA, Colantuoni E, et al. Sustaining reductions in catheter-related bloodstream infections in Michigan intensive care units; observational study. BMJ 2010; 340: c309.
  • 7. de Vries EN, Prins HA, Crolla R, et al. Effect of a comprehensive surgical safety system on patient outcomes. N Engl J Med 2010; 363: 1928-1937.
  • 8. Brown C, Lilford R. Evaluating service delivery interventions to enhance patient safety. BMJ 2008; 337: a2764.
  • 9. Evans SM, Scott IA, Johnson NP, et al. Development of clinical-quality registries in Australia: the way forward. Med J Aust 2011; 194: 360-363. <MJA full text>
  • 10. Runciman WB, Lumby J. Regulating clinical practice. In: Healy J, Dugdale P, editors. Patient safety first: responsive regulation in health care. Sydney: Allen and Unwin, 2009: 192-220.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.