Abstract
Substantial attention over the last decade has focused on ensuring improvement in the increasingly complex world of healthcare. This has resulted in significant efforts in the arena of patient safety. The issue of how best to evaluate the validity of patient safety initiatives is a matter of significant discussion. Many quality improvement initiatives in healthcare are poorly developed, with few patient safety interventions sharing characteristics with evidence based medicine. We will discuss the key elements of a framework as an example to help structure our thinking and approach to answer these questions. Elements include an explanation of the theoretical basis, the use of appropriate measures, detailing of the involved processes, assessment of the initiative itself as well as the contextual factors surrounding it.