From "Improving Quality Improvement Research" Effective Clinical Practice, January/February 2000. 3:40-44.
Figure 2. Potential effects of quality improvement efforts on overall performance. In the idealized model, targeted improvement efforts spill over to improve other aspects of care. In the zero-sum model, targeted improvement efforts distract providers from other aspects of care and paradoxically lower quality. The real effect of quality improvement efforts on other aspects of care is unknown.>