Hostname: page-component-7479d7b7d-m9pkr Total loading time: 0 Render date: 2024-07-11T00:10:50.373Z Has data issue: false hasContentIssue false
  • English
  • Français

The Application of Continuous Quality Improvement to Healthcare

Published online by Cambridge University Press:  21 June 2016

Michael D. Decker
Michael D. Decker*
Affiliation:
Department of Preventive Medicine and the Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medic&, Nashville, Tennessee
*
Department of Epidemiology, Saint Thomas Hospital, 4220 Harding Road, Nashville, TN 37205
Get access Rights & Permissions [Opens in a new window]

Extract

Last month,’ we described Continuous Quality Improvement (CQI), a general model for quality in any organized activity. CQI grew out of the concepts of Statistical Process Control developed in the 1930s by statistician Walter Shewhart. Shewhart believed that by measuring the outputs of any process, one could differentiate between variation from random fluctuations and variation that represented a loss of control over the process. Processes whose outputs remained within their control limits were considered to be under control. Processes that transgressed their control limits were out of statistical control, and adjustments were needed to return the process to control. The workers responsible for the processes could make the needed measurements and maintain the control charts themselves, allowing rapid detection and correction of unacceptable variation and enhancing the workers' sense of responsibility for the quality of the product.

A number of theoreticians, particularly W. Edwards Deming, Joseph M. Juran, and Philip B. Crosby, built on these concepts to develop CQI (also known as total quality management, total quality control, or industrial quality control). In CQI, quality is achieved through “a continuous effort by all members of the organization to meet the needs and expectations of the customer.” The term “customer” includes every person or group, within or outside the organization, who depends on the efforts or outputs of workers within the organization.

Type
Beyond Infection Control: The New Hospital Epidemiology
Information
Infection Control & Hospital Epidemiology , Volume 13 , Issue 4 , April 1992 , pp. 226 - 230
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References

1. Decker, MD. Continuous quality improvement. Infect Control Hosp Epidemiol. 1992;13:165–167.Google Scholar
2. Laffel, G, Blumenthal, D. The case for using industrial quality management science in healthcare organizations. JAMA. 1989;262:2869–2873.Google Scholar
3. James, BC. Quality Management for Healthcare Delivery. Chicago, Ill: The Hosoital Research and Education Trust of the American Hospital Association; 1989.Google Scholar
4. Cleat-y, PD, McNeil, BJ. Patient satisfaction as an indicator of quality care . Inquiry. 1988;25:25–36.Google Scholar
5. Joint Commission on Accreditation of Healthcare Organizations. The Joint Commission's Agenda for Change: Stimulating Continual Improvement in the Quality of Care, February 1990. Chicago, Ill: Joint Commission on Accreditation of Healthcare Organizations; 1990.Google Scholar
6. Joint Commission on Accreditation of Healthcare Organizations. A Brief Overview of the Joint Commission's Agenda for Change.’ Chicago, Ill: Joint Commission on Accreditation of Healthcare Organizations; 1987.Google Scholar
7. Joint Commission on the Accreditation of Healthcare Institutions. 1991 Accreditation Manual for Hospitals. Oakbrook Terrace, Ill: Joint Commission on the Accreditation of Healthcare Institutions; 1990.Google Scholar
8. Joint Commission on the Accreditation of Healthcare Institutions. 1992 Accreditation Manual for Hospitals. Oakbrook Terrace, Ill: Joint Commission on the Accreditation of Healthcare Institutions; 1991.Google Scholar
9. O'Leary, DS. Joint Commission begins shrinking AMH. Joint Commission Perspectives. 1990;10:2–3.Google Scholar
10. A leaner AMH expected in 1992. Joint Commission Perspectives. 1990;10:6–7.Google Scholar
11. Joint Commission on Accreditation of Healthcare Organizations. Principles of Organizational and Management Effectiveness for Health Care Organizations, March 1989. Chicago, Ill: Joint Commission on Accreditation of Healthcare Organizations; 1989.Google Scholar
12. Carroll, JG. Continuous quality improvement and its implications for accreditation standards. Top Health Rec Manage. 1991;11:27–37.Google Scholar
13. Decker, MD. Monitoring and evaluation. Infect Control Hosp Epidemiol. 1991;12:315–318.10.2307/30145200Google Scholar
14. Decker, MD. The development of indicators. Infect Control Hosp Epidemiol. 1991;12:490–492.Google Scholar

Introductory

1. Berwick, DM. Continuous improvement as an ideal in healthcare. N Engl J Med. 31989;320:53—56.Google Scholar
2. James, BC. Quality Management for Healthcare Delivery. Chicago, Ill: The Hospital Research and Education Trust of the American Hospital Association; 1989.Google Scholar
3. Laffel, G, Blumenthal, D. The case for using industrial quality management science in healthcare organizations. JAMA. 1989;262:2869–2873.Google Scholar
4. Spath, PL, ed. Innovations in Health Care Quality Measurement. Chicago, Ill: American Hospital Association; 1989.Google Scholar
5. Walton, M, ed. The Deming Management Method. New York, NY: Dodd, Mead, and Co.; 1986.Google Scholar

Advanced

1. Deming, WE. Out of the Crisis. Cambridge, Mass: MIT Center for Advanced Engineering Study; 1982.Google Scholar
2. Donabedian, A. The methods and findings of quality assessment: an illustrated analysis. Explorations in Quality Assessment and Monitoring, Volume III. Ann Arbor, Mich: Health Administration Press; 1980:80–125.Google Scholar
3. Ishikawa, K. Guide to Quality Control. White Plains, NY: Kraus International Publications; 1982.Google Scholar
4. Juran, JM. Juran on Planning for Quality. New York, NY: The Free Press (Macmillan, Inc); 1988.Google Scholar