For strategy consulting firms, the quality of the consulting has nothing to do with the size of the firm.

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With 7 million visitors to its site each month Health Grades keeps the pressure on hospitals to improve, says Michael Millenson, who runs consulting boutique Health Quality Advisors.

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Among the measures, the drugmaker said it has hired an independent pharmaceutical consulting firm to identify corrective actions to improve quality and manufacturing systems at its Fort Washington facility.

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They said they didn't like how the big consulting firms outsourced much of their research to third parties, which created data quality control problems.

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