ABSTRACT
Stewardship is one of the core BHCS values (see Introduction, Figure I.1), making the consumption of resources in relation to outcomes an important focal point of its quality improvement operations. A commitment to quality requires an investment of resources, which is critical to developing both the culture and the infrastructure to support improvement activities.1 While cost and quality are often integrally related, quality can be improved without increasing costs-and can even result in reduced costs. The Institute of Medicine has identified unnecessary health care costs that quality improvement could reduce or eliminate: those stemming from duplication of services and treating avoidable complications, and the inefficiencies that arise when a more expensive treatment produces comparable clinical outcomes.2 The goals of health care quality improvement should include obtaining better value for the resources expended; as such, the economic and other impacts associated with quality improvement initiatives need to be evaluated.2
