Phenomenon of quality and health-care: Snowball or an avalanche?

Joseph E. Ibrahim

Research output: Contribution to journalShort SurveyResearchpeer-review

2 Citations (Scopus)


The quality-of-care in health as a phenomenon is developing through small incremental steps. Some suggest this approach is too slow and more rapid change is warranted. It is possible to achieve more rapid change by reaching a 'tipping point' or a critical level. To reach a critical level requires (i) identifying key people, (ii) having an idea that sticks, and (iii) having the right context. Examples from selected aspects of quality in health-care including the use of report cards, recognition and remedial action for adverse events, the substantial reviews of health systems for quality-of-care suggest the critical level has been achieved. However, when the three rules for reaching the 'tipping point' are examined closely, it would seem that much more work is required to transform quality in health-care from a snowball into an avalanche.

Original languageEnglish
Pages (from-to)40-42
Number of pages3
JournalJournal of Quality in Clinical Practice
Issue number1-2
Publication statusPublished - 9 Jul 2001


  • Critical level
  • Quality and health-care
  • Tipping point

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