The need to build capability and capacity in quality improvement and patient safety.

The use of quality improvement (QI) methods and safety principles can improve child health outcomes and reduce harm. Multi-institution collaboratives have achieved improved results by identifying and implementing best practices and by using rigorous improvement methodology. Children’s hospitals and their partner academic institutions have redesigned not only specific aspects of patient treatment but also the fundamental processes that determine how care is given and how the work within hospitals is carried out and communicated. Although this progress is to be commended, more needs to be done. Significant variations in care and outcomes, and gaps in the capability of physicians to engage in and lead QI, continue to exist. These deficiencies could be remedied by increasing the availability of improvement curricula, training opportunities, and skilled faculty. An integrated approach to building capacity for quality and safety would connect children’s hospitals and their academic partners, addressing alignment of quality priorities and resources across organizations, education and training for physicians in the science of improvement, and recognition of the legitimacy of QI activities for professional development and career progression.