Chapter 5. Quality Improvement

  1. Brian H. Rowe MD, MSc, CCFP(EM), FCCP Professor Research Director
  1. Andrew Worster MD, CCPF (EM), MSc, FCFP Associate Professor1 and
  2. Ann McKibbon PhD Associate Professor2

Published Online: 27 FEB 2009

DOI: 10.1002/9781444303674.ch5

Evidence-Based Emergency Medicine

Evidence-Based Emergency Medicine

How to Cite

Worster, A. and McKibbon, A. (2008) Quality Improvement, in Evidence-Based Emergency Medicine (ed B. H. Rowe), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444303674.ch5

Editor Information

  1. Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada

Author Information

  1. 1

    Emergency Medicine, Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada

  2. 2

    Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada

Publication History

  1. Published Online: 27 FEB 2009
  2. Published Print: 31 OCT 2008

ISBN Information

Print ISBN: 9781405161435

Online ISBN: 9781444303674



  • quality improvement;
  • ST elevation myocardial infarction (STEMI);
  • steps in root cause analysis (RCA) approach to problem solving;
  • PubMed search - root cause analysis AND turnaround time;
  • Deming's simple four-step quality improvement method - plan, do, study, act (PDSA);
  • PubMed search: medical record review AND emergency medicine;
  • Root cause analysis (RCA) - powerful industry QI tool;
  • identification of root causes for delays for diagnostic imaging of ED patients;
  • PDSA cycle and RCA - QI instrument implemented without additional resources


This chapter contains sections titled:

  • Clinical scenario

  • Background

  • General search strategy

  • Clinical questions

  • Critical review of the literature

  • Conclusions

  • Acknowledgments

  • References