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Quality Improvement in Healthcare

Updated on April 2, 2014

Quality in Healthcare

Continuous Quality Improvement is a systematic approach to the measurement, evaluation, and improvement of the quality of care and service through the use of disciplined inquiry and teamwork. It emphasizes the following:

  • customer needs
  • staff participation and empowerment
  • analysis of work processes
  • measurement of system performance, and
  • continuous improvement of care and service

Quality Improvement is not a quick fix path to quality and it is not an easy undertaking, but many believe it is a change in approach that is key to the success of the health care industry.

  • Quality is defined as meeting and exceeding the needs of the customer.

The customer is the end-receiver of the work. There are external customers and internal customers. In healthcare, the external customer is usually the patient, the family, the responsible party, or the community. Internal customers are other staff members or departments in the facility, such as nursing, dietary, activities, pharmacy, and physical therapy -- anyone who has the role of end-receiver of a particular task performed in the organization.

A staff member will play different roles during the course of a day. He will usually be the provider of quality, but staff members can also be the customers when they are the end-receiver of a particular task performed in the facility.

  • Quality is achieved by improving the process.

The viewpoint of continuous quality improvement requires that the needs of the customer, whether external or internal, be assessed and clarified and that the process used to meet those needs be studied and improved.

The particular process or system may consist of all the steps that go into providing a particular care or service, such as assessing the patient, or obtaining information upon admission. It is the constant pursuit of meeting customer needs and systematic assessment and improvement of the process that is the heart of continuous quality improvement.

  • Process is studied through measurement and data collection.

In Quality Improvement, the improvement of a process is based on facts obtained by measuring performance and collecting statistical data. This data is analyzed and used to make improvements. Improvement does not flow from impressions or opinions.

  • Prevention is better than inspection.

The goal of Quality Improvement is improving the system so that errors are prevented, not finding the errors and fixing them after the fact.

The Joint Commission on Accreditation of Healthcare Organizations has embraced the concept of quality improvement. Its Agenda for Change is designed to make future accreditation an effective incentive for continuous improvement in the performance of healthcare organizations.

In addition, there are many healthcare facilities that have reported remarkable success using quality improvement tools. One facility reported that it took a hard look at its work processes and through continuous quality improvement was able to reduce the time taken to dispense medications by 35 percent, thereby increasing the timeliness of administration and decreasing overtime expenses. Another team was able to significantly decrease the incidence of postoperative abdominal wound infections through more timely administration of preoperative antibiotics, improved O.R. technique, and more effective wound management.

The history of continuous quality improvement boasts some impressive successes, but it also includes failures. Much has been written about what it takes to succeed. The important points on which the experts agree are:

strong leadership

  • training of both management and staff
  • the users must feel empowered to use what they know
  • removal of barriers between departments to increase communication
  • being able to have sense of security to openly ask questions and express opinions

It is vital that they understand that Quality Improvement is a way of studying and improving the system, not a vehicle for blaming individuals for errors.

Quality Improvement is a way of pulling together to achieve quality improvement through teamwork so that everyone can be proud of the work they do.


Grohar-Murray, M., & Langan, J. (2011). Leadership and management in nursing (4 ed.). Boston: Pearson.

Iasis Healthcare E-Assisted Learning. (n.d.).



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