Managing the healthcare system is a daunting task. Every healthcare care organization searches for technologies at a lower cost; therefore, it becomes mandatory to improve healthcare.
Continuous Quality Improvement (CQI) aims at improving results while lowering the costs through systematic adjustments. It is used by hospitals and other healthcare organizations to optimize clinical care by reducing costs and meeting regulatory requirements. It analyzes patients and provides better healthcare.
Several Continuous Quality Improvement(CQI) programs exist to help the organization to improve efficiency and patient outcomes.
History of CQI in Healthcare
In 1910 and 1920s, Western Electric Engineer Walter Shewhart, who is known as the ‘Father of Quality Control,’ began working for quality control in a manufacturing firm. He began working on improving processes and became the pillar of quality improvement.
In the 1950s, an American engineer, W. Edwards Deming, supported Shewhart's work in manufacturing processes. At the same time, Joseph Juran, an American engineer, focused on quality management. He was the first theory leader to write about poor quality.
In 1966, a physician, Dr. Avedis Donabedian, published “Evaluating the Quality of Medical Care” and presented a model for analyzing an organization structure and outcomes. In 1989, the US Congress created an agency, now called the Agency for Healthcare Research and Quality (AHRQ). It aims to focus on research and look for the guidelines for health practices.
In 1991, the nonprofit Institute for Healthcare Improvement was co-founded by a pediatrician, Donald Berwick. It remains a leading nonprofit organization in encouraging healthcare improvement. In 2001, the IOM published “Crossing the Quality Chasm.” It outlines the aims for quality improvement.
Major Models of CQI in Healthcare
Several CQI models help organizations to perform quality improvement. Here are basic CQI models in healthcare.
It describes a principle-based CQI management system based on the Toyota Production System. It has two fundamental elements - a systematic approach to process improvement by eliminating waste and a commitment to challenge and to develop the people who work to create a culture of improvement. Its principles have applied to several hospitals and throughout the world to reduce costs and to improve quality.
Using lean principles by any healthcare organization would specify where values come from and add the services that add value. Lean pulls together different processes and workflows. It focuses on reducing overproduction, transportation, and processes that don’t add value.
2. Care Model
It focuses on promoting prevention and upfront care. It establishes different aspects of care and emphasizes patient safety and time to reduce harmful delays.
Additionally, it is equitable for everyone- irrespective of gender, status, and other characteristics. It expects that all parties should participate in improving the system.
3. Six Sigma
It emphasizes on reducing errors and building a network of specialists in the methodology through Six Sigma certifications. The experts can help the organization to enhance the quality and to focus on quality assurance. It uses five principals. Firstly, it defines a mapping stage to decide the process also process inputs and the project scope.
It measures the process performance and its results through data. The data can be collected through surveys. It analyzes the data and tracks how the process is doing. Then it measures the improvement based on results. If it doesn’t show improvement, then changes to the process were not correct. It regularly monitors the process and reviews new ways to optimize.
4. PSDA (Plan-Do-Study-Act)
In this model, the team asks what we want to achieve, what changes can we make to make improvements, and how will we identify improvement has resulted by bringing about the changes. Within a framework of PSDA, a team rapidly deploys the processes and then reviews them. This cycle consists of different steps.
It creates the team and includes the right experts who can identify the areas that need to change. It establishes goals to outline what the team wants to achieve. It tests changes to confirm whether the goal is achieved. It implements the changes and then disseminates to the organization.
Impact of CQI (Continuous Quality Improvement)
CQI is a structured organizational process that involves people in planning and executing a continuous flow of improvement to provide quality health care to meet the expectations. There are four key elements of CQI.
First, implemented in or by health care service. Second, collecting quantitative data, third, reporting data, and fourth aiming to change how the delivery of care is structured. The models can vary depending on the health-care services and the external environment.
According to studies, the reports reduced hospital admissions, improved professionals practice, and delivered better health outcomes. It also documented increased capacities and workforce capabilities to deliver the best outcomes.
What Pediatric Hospital Should Distinguish and Know About the Principles of CQI
Pediatric hospitals should distinguish the principles of CQI and focus on improving the process of care. They should explain how CQI focuses on improvement and can be used to create clinical care plans and hospital guidelines. It should describe the business case for quality and discuss the CQI concept and methods behind PSDA.
Furthermore, it should define the role of human factors in implementing healthcare improvements. It summarizes the CQI support and the development of care standardization and practice guidelines. The hospitals should list the necessary attributes to facilitate and to lead the patient safety initiatives. The team should engage the hospital’s senior management, staff leadership, and improvement goals.
They should discuss the value of state and local comparative quality data and the utility of national sources like PHIs (Pediatric Health Information Dataset).
Pediatric Hospitalists should serve as a liaison between the hospital’s staff and physician staff when exchanging information and results. They should educate trainers and peers, depending on the principles of CQI. They should use best practice guidelines and demonstrate proficiency while utilizing the PSDA process.
Advantages of Continuous Quality of Improvement in Healthcare
CQI mainly focuses on sub-optimal processes in business and to improve quality. Know the benefits CQI offers to healthcare.
1. Error Reduction
It reduces errors in the outcomes. Sometimes, defective products and mistakes made during services can be costly. It emphasizes on identifying potential sources and fixing them to avoid problems.
2. Increased Productivity and Adaptability
It allows healthcare professionals to adopt the changes going in the healthcare industry. The organizations continuously implement changes and adapt business trends according to market changes. Also, continuous quality improvement leads to increased productivity in the long term.
3. New Initiatives
When the focus is on improving quality, new opportunities come up. It offers fewer returns, and less time is spent in detecting errors.
CQI is a great method for focusing on the quality of performance of a radiology department. It is a process that analyzes how an organization works and what are the ways to improve its process.