Skip to main content

Basics of Quality Improvement

  • Chapter
  • First Online:
Medical Quality Management

Abstract

In today’s healthcare field, an increasing focus is placed on medical errors, cost-effective medicine, public reporting, and pay for performance. As a result, payers and patients have turned to quality improvement (QI) as a strategy and framework to address specific concerns within the current healthcare system. Internal QI is vital to the ability of a healthcare organization or practice to fulfill many goals including, but not limited to, maintaining the fiduciary relationship between the physician and the patient, enhancing medical care and care delivery, simplifying and streamlining procedures, reducing costs, increasing patient and provider satisfaction, and enhancing workplace morale and productivity. External QI is crucial for physician education, licensure and certification, benchmarking, accreditation, and health policy formulation. This chapter introduces quality management theories and practices that have evolved over the past 40 years and highlights some of the themes that have marked progress within the field. It also addresses the policies, philosophies, and processes that characterize the QI field today.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 89.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Harris-Wehling J (1990) Defining quality of care. In: Institute of Medicine, Medicare: a strategy for quality assurance: volume II sources and methods. National Academies Press, Washington, DC, p 5

    Google Scholar 

  2. Agency for Healthcare Research and Quality (2013) Module 4. approaches to quality improvement. In: Practice facilitation handbook. http://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod4.html. Accessed May 2013

  3. Crosby PB (1979) Quality is free: the art of making quality certain. McGraw-Hill, New York

    Google Scholar 

  4. Codman EA (1914) The product of a hospital. Surg Gynecol Obstet 18:491–496

    Google Scholar 

  5. Donabedian A (1985) The methods and findings of quality assessment and monitoring, vols I, II, III. Health Administration Press, Ann Arbor

    Google Scholar 

  6. Shewhart W (1931) Economic control of quality of manufactured product. D. Van Nostrand Co, New York

    Google Scholar 

  7. Deming WE (1986) Out of the crisis. MIT Press, Cambridge

    Google Scholar 

  8. Juran J (1989) Juran on leadership for quality. Free Press, New York

    Google Scholar 

  9. Gustafson D, Hundt A (1995) Findings of innovation research applied to quality management principles for health care. Health Care Management Rev 20(2):16–33

    Article  CAS  Google Scholar 

  10. Chassin M, Galvin R, National Roundtable on Health Care Quality (1998) The urgent need to improve health care quality. JAMA 280(11):1000–1005. https://doi.org/10.1001/jama.280.11.1000

    Article  CAS  PubMed  Google Scholar 

  11. Kohn L, Corrigan J, Donaldson M (eds) (1999) To err is human: building a safer health system. National Academies Press, Washington, DC

    Google Scholar 

  12. James J (2013) A new evidence based estimate of patient harms associated with hospital care. J Patient Saf 9(3):122–1128. https://doi.org/10.1097/PTS.0b013e3182948a69

    Article  PubMed  Google Scholar 

  13. Institute of Medicine (2001) Crossing the quality chasm: a new health system for the 21st century. National Academies Press, Washington, DC

    Google Scholar 

  14. Chassin M, Loeb J, Schmaltz S et al (2010) Accountability measures–using measurement to promote quality improvement. NEJM 363(7):683–688. https://doi.org/10.1056/NEJMsb1002320

    Article  CAS  PubMed  Google Scholar 

  15. Holland C, Foley K, Asher A (2015) Can big data bridge the chasm? Issues, opportunities and strategies for the evolving value-based health care system. Neurosurg Focus 39(6):E2. https://doi.org/10.3171/2015.9.FOCUS15497

    Article  PubMed  Google Scholar 

  16. Walsh K, Ettinger W, Klugman R (2009) Physician quality officer: a new model for engaging physicians in quality improvement. Am J Med Qual 24(4):295–301. https://doi.org/10.1177/1062860609336219

    Article  PubMed  Google Scholar 

  17. Malenka D, O’Connor G, Northern New England Cardiovascular Study Group (1995) A regional collaborative effort for CQI in cardiovascular disease. Jt Comm J Qual Improv 21(11):627–633

    CAS  PubMed  Google Scholar 

  18. Antony J (2011) Six Sigma vs lean: some perspectives from leading academics and practitioners. Int J Prod Perform Manag 60(2):185–190. https://doi.org/10.1108/17410401111101494

    Article  Google Scholar 

  19. Varkey P, Reller MK, Resar R (2007) The basics of quality improvement in healthcare. Mayo Clin Proc 82(6):735–739. https://doi.org/10.4065/82.6.735

    Article  PubMed  Google Scholar 

  20. Langley G, Moen R, Nolan K et al (1996) The improvement guide: a practical approach to enhancing organizational performance. Jossey-Bass, Hackensack

    Google Scholar 

  21. Goldstein M (2001) Six Sigma program success factors. Six Sigma Forum Magazine 1(1):36–45

    Google Scholar 

  22. Cherry J, Seshadri S (2000) Using statistics to reduce process variability and costs in radiology. Radiol Manage 8(1):42–45

    Google Scholar 

  23. Womack J, Jones D (1996) Lean thinking: banish waste and create wealth in your corporation. Simon and Schuster, New York

    Google Scholar 

  24. Young D (2002) Pittsburgh hospitals band together to reduce medication errors. Am J Health Syst Pharm 59(11):1014, 1016, 1026

    PubMed  Google Scholar 

  25. Mazzocato M, Stenfors-Hayes T, Schwarz U et al (2016) Kaizen practice in healthcare: a qualitative analysis of hospital employees’ suggestions for improvement. BMJ Open 6:e012256. https://doi.org/10.1136/bmjopen-2016-012256

    Article  PubMed  PubMed Central  Google Scholar 

  26. Ahlstrom P (2004) Lean service operations: translating lean production principles to service operations. Int J Ser Technol Manag 5:545–564. https://doi.org/10.1504/IJSTM.2004.006284

    Article  Google Scholar 

  27. Goldberg H, Wagner E, Fihn S et al (1998) A randomized controlled trial of CQI teams and academic detailing: can they alter compliance with guidelines? Jt Comm J Qual Improv 24(3):130–142

    CAS  PubMed  Google Scholar 

  28. Kiefe C, Allison J, Williams O et al (2001) Improving quality improvement using achievable benchmarks for physician feedback: a randomized controlled trial. JAMA 285(22):2871–2879

    Article  CAS  Google Scholar 

  29. Perneger T (2004) Why we need ethical oversight of quality improvement projects. Int J Qual Health Care 16(5):343–344. https://doi.org/10.1093/intghc/mzh075

    Article  PubMed  Google Scholar 

  30. Malinak J, Press M, Rajkumar R et al (2017) Principles for provider incentives in CMS’s alternative payment models. Healthcare 5(1–2):9–11. https://doi.org/10.1016/j.hjdsi.2016.05.001

    Article  PubMed  Google Scholar 

  31. McClellan M, McKethan A, Lewis J et al (2010) A national strategy to put accountable care into practice. Health Aff 29(5):982–990. https://doi.org/10.1377/hlthaff.2010.0194

    Article  Google Scholar 

  32. Shortell S, Casalino L, Fisher E (2010) How the Centers for Medicare & Medicaid innovation should test accountable care organizations. Health Aff 29(7):1293–1298

    Article  Google Scholar 

Additional Resources-Further Reading

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 American College of Medical Quality (ACMQ)

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Caldwell, J., Varkey, P. (2021). Basics of Quality Improvement. In: Giardino, A., Riesenberg, L., Varkey, P. (eds) Medical Quality Management. Springer, Cham. https://doi.org/10.1007/978-3-030-48080-6_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-48080-6_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-48079-0

  • Online ISBN: 978-3-030-48080-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics