Table 1.

Comparison of the traditional and a new approach of the medical profession to improving quality

	Traditional approach	New approach
Attitude	Quality is what we do	Quality is what we strive for
Scope	Clinical effectiveness	Multiple dimensions of quality
Focus	Patients (populations)	Patients/populations and systems
Requisites	Standards delivered by high quality education	Continuous improvement through learning
Knowledge base	Bio‐science based on the scientific method	Biomedicine plus behavioural sciences
Scale	Large scale ‘roll‐out’ of evidence	Small scale testing and context‐specific spread