The opportunity to mobilize linkages between quality improvement (QI) and research is at an early stage. This article describes some of the opportunities for and challenges of integrating QI and more traditional forms of clinical research to achieve broad improvements in medical care. The authors suggest that such integration would include more active experimentation in the health care delivery system and that the application of QI methods offers a rational, effective, and reasonably fast method to support the learning required to adapt new knowledge to specific practice environments and to create and test innovations needed to improve systems of care delivery.