Implementing continuous quality improvement in general practice: the whole package or a series of projects?

Continuous quality improvement is a complex approach to improvement that describes an all encompassing “package” of principles, methods, and techniques (box). For large organisations setting out to change working practices in line with the principles of continuous quality improvement, implementation of the complete package may be appropriate. But for much smaller organisations with fewer resources—such as general practices—such a task may seem overwhelming. Yet continuous quality improvement has been shown to work in general practice. 2 The evidence suggests, however, that implementing it gradually, starting with small scale projects, may be more successful in general practice, and a quality improvement report in this issue adds further support for this approach.