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There are still major efforts needed to continuously improve. More focus needs to be put on measuring internal processes, costs, and components of quality other than accuracy. Documentation needs to be regularly updated, methods for incorporating Big Data developed, and flexibility improved so that adaptive methods based on paradata can be used.

it takes regular management involvement and procedures to be in place for it to succeed

Measurements are vital, but they are not the goal. This will require re-focusing on improving internal processes. It also implies recognizing the need to track costs as a component of quality.