... Nembhard1,2 and Harlan M Krumholz1,3Address: 1Division of Health Policy and Administration, School of Public Health, Yale University School of Medicine, New Haven, CT, USA, 2Yale School of Management, ... http://www.implementationscience.com/content/4/1/25Page 2 of 11(page number not for citation purposes)IntroductionDespite decades of efforts to improve quality of healthcare, poor performance persists in many aspects of care.Patients often ... deviance approach to alternative methods of identify-ing best practices, including standard biomedical and epidemiologic research and quality improvement and action research. In the fourth section,...