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Why Don Berwick Is Almost Right: How Public Health Quality Improvement Operates Within Complex Systems

Beitsch, Leslie M. MD, JD; Moran, John PhD, MBA, CMQ/OE, CQIA, CMC; Duffy, Grace CMQ/OE, CQIA, CLSSMBB

Journal of Public Health Management and Practice: January/February 2012 - Volume 18 - Issue 1 - p 70–73
doi: 10.1097/PHH.0b013e31822ca3d3

In this commentary the authors offer explanation for some differences between health care and public health quality improvement. The authors also provide a model that may help guide health departments as they navigate implementation of quality improvement in the complex public health systems in which they practice.

Center for Medicine and Public Health, Florida State University College of Medicine, Tallahassee (Dr Beitsch); Public Health Foundation, Washington, District of Colombia (Dr Moran and Ms Duffy); and University of Minnesota School of Public Health, Minneapolis (Dr Moran).

Correspondence: Leslie M. Beitsch, MD, JD, 1115 W Call St, Tallahassee, FL 32306 (

Disclosure: The authors declare no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.