A systematic approach to develop a research agenda for improving the quality of emergency care is presented. This approach is based on the six domains of quality outlined by the Institute of Medicine (effective, timely, efficient, safe, patient-centered, and equitable care) and a sequence of four research steps (evidence, synthesis, assessment, and intervention). Examples related to the care of patients with acute myocardial infarction are used to illustrate the proposed approach. Examples of other emergency medicine research topics relevant to the Institute of Medicine quality domains are also presented. Research to improve the quality of emergency care can benefit from a more systematic consideration of the domains of quality and the research steps necessary to generate evidence and inform quality improvement efforts in practice.