Foreword: A Great Start and A Long Way to Go

Abstract

Could any of us have imagined how far the field of pediatric quality improvement would come in less than two decades? The number of individuals who were committing their careers to pediatric quality—either through research or management—could likely have fit within a telephone booth, and certainly within a minivan, in the early 1990s. In looking at the contents of this issue of the Pediatric Clinics of North America, it is clear how far our field has come—how much greater the breadth and number of individuals involved, how much deeper our understanding of the nature of our quality problem, how much improved our tools are to measure quality and our methods are for taking action to improve performance. We now can point to real beacons of success, actual programs that have made dramatic improvements in removing the excuse that ‘‘it cannot be done in health care.’’ At this time of hope, renewal, and opportunity in the United States of America, it is worth reflecting on what has contributed to the successes that these articles describe and the growth in our field, as well as challenges ahead and what we need do to better achieve the goal of our movement—a world in which all children receive the health care they need.

Our field has made tremendous advances over the past two decades. We have reduced harm and improved quality in numerous settings. While we continue to refine both measurement and quality improvement technical approaches, we must also define the system changes that will lead to dramatically better outcomes, identify the policies that will promote the adoption of this system, and build the coalitions and seize the opportunities to move these policies into practice.