Poots AJ, Reed JE, Woodcock T, Bell D, Goldmann D. How to attribute causality in quality improvement: Lessons from epidemiology. BMJ Quality and Safety. 2017;26(11):933-937.
There is increasing need to demonstrate impact to justify investment of time and resources in implementing and scaling up quality improvement and implementation (QI&I) interventions, which is a particular challenge in health care since interventions often are multimodal and applied in complex systems. This article proposes QI&I initiatives, regardless of scope and resources, can be enhanced by applying epidemiological principles adapted from Bradford Hill Criteria to strengthen evidence of effectiveness.
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