Beyond the Quality Illusion: The Learning Era

By highlighting the intangible, personal, contextual, and illusory nature of “quality,” the authors reconceptualize quality improvement as a pluralistic and moral journey. They imagine a new era of quality improvement in which patients and health care providers work together to understand and achieve quality. The authors recommend, for the path forward, a “travel kit” of 10 crucial elements—compassion, deliberation, flexible goals, ownership, the engagement of patients, the inclusion of payers, the involvement of learners, feedback loops, the fostering of learning, and the application of different sources of knowledge—to reframe quality improvement in a new era of learning.