SPECIAL COMMUNICATION Determining When Quality Improvement Initiatives Should Be Considered Research Proposed Criteria and Potential Implications

RECENT DEVELOPMENTS INhealth care have been associ-ated with a large number ofinitiatives aimed at improv-ing the quality of health care. Many of these initiatives are described as qual-ity improvement (QI). Quality improve-ment has become a major force in shap-ing health care and eliciting rapid change with the goal of improving the quality of health care provided by hos-pitals, clinics, and health care systems.1 However, it is often unclear when QI initiatives are also research. This dis-tinction is not simply a descriptive con-venience. Whether a QI initiative is also classified as research may determine whether that effort is reviewed before i