Abstract
Your clinic has decided to undertake a quality-improvement initiative for patients with low back pain. A steering committee has recommended implementing a set of evidence-based guidelines developed through the sponsorship of the Agency for Health Care Policy and Research. Strategies are now in place to modify your guidelines and your colleagues' prescribing practices with regard to bed rest, use of imaging studies, and days off from work. Always the skeptic, you ask your medical director, “How will we know if following these guidelines has done any good?”