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To make improvements, an organization needs to understand its own delivery system and key processes. The concepts behind most QI approaches recognize that both resources (inputs) and activities carried out (processes) are addressed together to ensure or improve quality of care (outputs/outcomes). A health service delivery system can be small and simple, such as, an immunization clinic, or large and complex, like a large managed-care organization. QI can assume many forms and is most effective if it is individualized to meet the needs of a specific organization’s health service delivery system.