Developing a service line approach to quality improvement.

A specialty hospital in New England is undergoing a radical change in its quality program. It is shifting from a traditional quality assurance structure with 41 segregated committees to an integrated model based on service lines. The goals for this shift were fourfold: to reduce duplication of effort, to improve the level of integration of quality efforts across disciplines, to design a comprehensive system to evaluate care, and to enhance the communication of quality efforts. The article describes the rationale for selecting a service line model for performance improvement, the process of setting this change in motion, and the lessons learned along the way.