Improving health care .4. Concepts for improving any clinical process

This article offers a method for the design of changes for improving outcomes and lowering costs of patient care. This is the fourth article in a series focusing on the practical work of making improvements in the quality and value of health care. Part I, ''The Clinical Value Compass,'' which appeared in the April 1996 issue, provided a panoramic view of quality and value in health care and offered instruction on how to construct a Clinical Value Compass. Part 2, ''A Clinical Improvement Worksheet and Users' Manual'' (August 1996), built on the framework laid out in Part 1 and provided guidance on the total improvement process. Part 3, ''Clinical Benchmarking for Best-Patient Care'' (September 1996), introduced a process for benchmarking that can help generate usable ideas about best practices.