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The editorial board members of MEDSURG Nursing are pleased to publish many impressive quality improvement (QI) articles. Readers may find the projects reported in these articles helpful in examining areas of needed improvement on their own units, but an understanding of the nature of quality improvement is important to reading project results as well as conducting QI initiatives.
Kovner, Brewer, Yingrengreung, and Fairchild (2010) found 38.6% of novice nurses in a national study reported their preparation in QI measures to be poor or very poor. Some in the study had not heard the term and half of the participants indicated they were "not at all prepared" to use QI techniques such as root cause analysis. Selected QI topics have been covered in this column and other articles in this journal. To continue to support readers, I will provide a series of columns on key aspects of QI with appropriate references. In this column, an overview of quality improvement will be provided.
Purpose of Quality Improvement
Concern with quality health care is not new. Ignaz Semmelweis, a 19 th century obstetrician, championed handwashing at a time when most physicians thought it unimportant (White, 2016). Florence Nightingale determined poor living conditions led to high death rates in soldiers as well as citizens of London. Her polar area diagram showing the mortality statistics in the Crimean War is well-known (Lloyd, 2019). Many organizations, including The Joint Commission and Medicare and Medicaid programs of the U.S. government, have worked to improve healthcare quality.
A frequently cited definition of QI from the U.S. Department of Health and Human Services (2011) indicates quality improvement "consists of systematic and continuous actions that lead to measureable improvement in health care services and the health status of targeted patient groups" (p. 1). Quality improvement is a data-driven improvement process for a specific organization (Hain, 2017). The purpose of QI activities is to improve the care of patients and therefore improve patient outcomes. When conducting QI work, healthcare providers are not interested in generalization to large populations such as investigators would be when conducting research. In QI, providers are interested in the patients the facility or agency serves.
Concern for quality is everyone's responsibility at every level of the organization. Monitoring and improving quality is...