CLOSING THE GAP BETWEEN MEDICAL KNOWLEDGE AND PATIENT OUTCOMES THROUGH NEW TRAINING INFRASTRUCTURE.

The biomedical research infrastructure of our academic medical centers elucidates disease mechanisms and develops diagnostic tests and treatments with scientific rigor, but the mechanism for reliably moving these findings into clinical settings lacks careful design. Hence, there is a wide gap between medical discoveries and the health benefit realized by the U.S. population. Performance improvement (PI) is a discipline that focuses on intentional redesign of core processes in our health system to close these gaps. The application of PI science is more consequential to health outcomes as is traditional biomedical research. This article describes why application and recognition of PI science as a discipline is imperative and why we should require training with similar intensity in undergraduate medical education (UME) and graduate medical education (GME). It also proposes investment in infrastructure (developing faculty expertise) and rigorous fellowships, which are, perhaps, more likely to thrive in teaching hospitals with a strong clinical mission.