Despite the promise of psychiatric rehabilitation, many programs fail to in
corporate innovative rehabilitation practices into their day-to-day regimen
s. Performance improvement is an effective paradigm for helping agencies im
prove the quality of their programs. Four phases of performance improvement
are reviewed in this article: organizing for change, preparing the environ
ment, focusing the environment, and maintaining improvement. Implementing t
he four phases of performance improvement is illustrated in a case study. M
ethodological rigor of data generated by performance improvement teams is a
lso discussed.