To the Editor: Dr Casarett and colleagues1 claim that virtually all QI interventions are generalizable.
I disagree. How well inpatients at my hospital like the food relates solely
to how well inpatients at my hospital like the food and cannot be generalized
to another hospital. Contrary to the authors' conclusions, I would describe
such an inpatient satisfaction survey as not generalizable and therefore not
research. Similarly, a chart review to determine how long patients wait for
a procedure at a particular institution is not generalizable. The determination
of whether an investigation is generalizable remains an important and usually
easily recognized factor that classifies most QI activities as different from
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