Content area
Full Text
With the rapid expansion of knowledge and technology and a health care system that performs far below acceptable levels for ensuring patient safety and needs, front-line health care professionals must understand the basics of quality improvement methodologies and terminology. The goals of this review are to provide clinicians with sufficient Information to understand the fundamentals of quality Improvement, provide a starting point for Improvement projects, and stimulate further Inquiry into the quality Improvement methodologies currently being used in health care. Key quality Improvement concepts and methodologies, Including plando-study-act, six-sigma, and lean strategies, are discussed, and the differences between quality Improvement and quallty-of-care research are explored.
Mayo Clin Proc. 2007;82(6):735-739
CQI = continuous quality Improvement; DPMO = defects per million opportunities; PDSA = plan-do-study-act; QI = quality Improvement; TPS = Toyota Production System; VSM = value stream mapping
In the past 2 decades, innumerable advances have occurred in medicine and technology. However, the health care system continues to perform far below acceptable levels in the areas of ensuring patient safety and addressing patient needs.1 The publication To Err is Human from the Institute of Medicine galvanized health care system response and public demand for change when the US population learned that medical errors cause 44,000 to 98,000 deaths annually.2 The abyss between what physicians know should be done for patients and what is actually done accounts for more than $9 billion per year in lost productivity and nearly $2 billion per year in hospital costs.3
Despite our complex medical environment, physicians rely primarily on paper tools, memory, and hard work to improve the care given to patients. However, creation of reliable and sustained improvement in health care is difficult with use of traditional methods. Improvement often requires deliberate redesign of processes based on knowledge of human factors (how people interact with products and processes) and tools known to assist improvement. The clear ethical imperative to enhance the quality and safety of care and meet external accreditation requirements and consumer expectations requires physicians to address qualityof-care issues systematically.45
The goals of this review are to provide clinicians with sufficient information to understand the basics of quality improvement (QI), highlight the basics of major improvement methodologies, provide a starting point for improvement projects, and stimulate further inquiry...