While PDSA, Lean, and Six Sigma are approaches to help practices in change and overall improvement, there are several evidence-based tactics and interventions that can lead to improved outcomes when implemented in a systematic manner. The ERIC Project (Expert Recommendations for Implementing Change) (PDF, 604 KB) has compiled a list of 73 tactics to facilitate change in a variety of settings. While not every one of the approaches is useful to the improvement of diabetes care, the list is extensive and can be used as a guide for practices.
The quality improvement movement is still in its early stages. Much has yet to be learned about the optimal approaches and techniques to improve quality. Some authors have suggested significant limitations to the existing scientific basis for quality improvement and have raised the bar for future scientists and authors to be more rigorous in trial design.