I tend to consider the QI process to work in a cycle of evaluation, planning, implementation, and review. Based on your experience, which step in this process is the slowest? I find it interesting to see the process in this way, because if we can speed up the rate limiting step, we can dramatically improve the pace at which public health improves.
I'm a recent graduate, so my experience is very limited. However, from my perspective I think the evaluation part is the slowest. It takes so long to get IRB approval (if required), recruit the people you want to study, collect the data (for long cohort studies this can take decades), analyze the data, and so on. That's not to mention the resources spent in this whole process! I'd say the implementation process is the second slowest, just because policy takes so long to draft and actually make it through to implementation (if it makes it at all).
As a follow up question for those of you who don't see the QI process in this manner, how do you conceptualize it? How would you going about improving the speed at which public health improves?