Skip Navigation

What is Continuous Quality Improvement?

Florence Nightingale

Continuous Quality Improvement (CQI) is a method of improving patient outcomes that is proactive, self-evaluating, and focused on optimal care. The concepts of CQI are based on the work of Edwards Deming and Joseph Juran with the automobile industry, but the roots of CQI in healthcare go back to the days of Florence Nightingale. Her Notes on Nursing and analysis of mortality during the Crimean War were initial steps into this area.

"The purpose of any health care quality program must be to improve care and service. This statement sounds logical and obvious, yet it is amazing to see how far off the track some programs have veered. We review records, we revise documentation forms, we log reports. But how often can we say that we have actually improved the care or service received by patients? Quality Assurance and quality improvement have given us good tools to assess, assure, or improve quality, yet we need to go further in tailoring them to create the greatest impact at the clinical level. To do so, clinicians just lead the way. Clinicians must continue to learn about quality. They must share the discovery of their experience with others, struggling to improve the clinical quality." (Schroeder, 1991)

What do I need to do to get started?

Understand where you want to go

  • Network 11 Medical Review Committee Recommendations
  • DOQI Guidelines

Find out where you are

  • Look at your data, displayed over time
  • Identify areas for improvement
  • Identify causes for poor results

Implement the PDCA cycle

  • PLAN: Develop new or improved processes that will fix identified problems
  • DO: Implement the new process in a limited pilot study
  • CHECK: Evaluate the results
  • ACT: Based on the evaluation, make necessary changes and then implement unit-wide

References:

Harbert, G., Wick, G. (1995). Continuous Quality Improvement: From Concept to Reality (pp. 5-9). Pittman, NF: American Nephrology Nurses Association

Schroeder, P.S. (1991). Nursing Standards: The basis of professional practice. The Encyclopedia of Nursing Care Quality, pp. 2-3.