Why is quality improvement important for primary care practices engaging primary care practices in quality improvement qi activities is essential to achieving the triple aim of improving the health of the population enhancing patient experiences and outcomes and reducing the per capita cost of care and to improving provider experience. Ensuring patients receive care that is safe and of high quality is an essential part of modern healthcare to help with this there are growing numbers of evidence based quality improvement qi methods that can help practitioners to assess and improve the care they provide. Quality is a direct outcome of the primary health care principles of equity accessibility cost effectiveness sustainability and partnership with the community therefore quality assurance and improvement in primary health care continues to top the agenda for most countries of the world including those in the who eastern mediterranean region this manual describes the concept and . Quality improvement in primary care to prevent hospitalisations and improve effectiveness and efficiency of care for people living with coronary heart disease quel protocol for a 24 month cluster randomised controlled trial in primary care redfern j123 hafiz n4 hyun k4 knight a56 hespe c7 chow ck48 briffa t9 gallagher r10 reid c11 hare dl12 zwar n13 . Although primary care practices are under increased pressure to improve care quality little attention has been devoted to assessing and building the inherent ability of primary care practices to effectively conduct quality improvement activities 123this qi capacity has been defined as the ability of a primary care practice to engage in qi activities in a continuous and