Healthcare Quality Improvements


It is important to understand what Quality improvements are and how it can be used in the healthcare industry. Quality Improvements is a very dynamic and complex topic and

to further complicate an already complex topic, there are dozens of quality improvement definitions. Before health systems can implement successful quality improvement programs, they need useful, pragmatic definitions to guide their efforts. Focusing on the most useful definitions will be helpful. When Deming and others developed their approach to modern quality improvement starting about 75 years ago, they were basically developing a way for modern organizations to deal with the complex challenges that were confronting them. The approach they developed to improvement was remarkably simple, yet extraordinarily powerful. It’s centered on the fact that quality improvement is really about process management. These quality improvement concepts and techniques have been used to transform almost every major industry in the world with dramatic results. The last holdouts, the last passions of resistance, are primarily healthcare, higher education, and government. Now, it’s happening to healthcare. I believe higher education is imminent; it’s anyone’s guess whether the government will ever succumb to these forces.

In defining Quality Improvements, the CDC’s definition focuses on activities that improve population health, ensure healthcare’s affordability, and deliver the best patient experience. These three dimensions mirror The Institute for Healthcare Improvement (IHI) Triple Aim; the framework all quality improvement in healthcare ties back to:

  • Improve the health of populations.
  • Reduce the per capita cost of healthcare.
  • Improve the patient experience.

The Triple Aim is a framework for optimizing health system performance. And the primary goal of quality improvement is to improve outcomes. CDC also describes quality improvement as one component of the performance management system, which has three defining characteristics: It uses data for decisions to improve policies, programs, and outcomes. It manages change. And it creates a learning organization.

Now in understanding Healthcare Quality Improvements, we all know healthcare is very complex, but it’s really not fundamentally different from other industries. Healthcare is really made up simply of thousands of interlinked processes that result in a very complex system. If we focus on the processes of care one at a time, we can fundamentally change the game and deal with the challenges facing healthcare. Now, this may seem like a tall order, but Pareto’s principle tells us that there are probably 20% of those processes that will get us 80% of the impact. So the challenge of every organization is to identify that 20%, roll up their sleeves, and begin the important work of addressing those challenges.

Deming clearly understood the importance of data. Meaningful quality improvement must be data-driven. This is particularly true in healthcare. You’re basically dead in the water if you try to work with healthcare providers and you don’t have good data. I think everybody recognizes that: If you cannot measure it…You cannot improve it.

In addition to properly measuring quality improvements, all Quality Improvement should also be continuous.

Quality improvement can’t happen without constant measurement and evaluation. Although it is possible to implement the quality improvement cycle once, single cycle improvement isn’t quality improvement in the purest sense; it eliminates the critical “study” step in the “plan, do, study, and act” sequence; the evaluative step that’s so critical for successful quality improvements.

Continuous quality improvement is about sustaining and hardwiring the right behaviors. For example, if a health system reduces its heart failure readmission rate, it shouldn’t just check that item off the “to do list” and move on to something else within its cardiovascular program. It still needs to dedicate valuable resources to the readmissions initiative to ensure outcomes are sustained; to make sure the interventions continue to be effective.