Ransom, E. R, Joshi, M. S., Nash, D. B., & Ransom, S. B. (2008). The healthcare quality book:
Vision, strategy, and tools. (2nd ed.). Health Administration Press: Chicago, IL.
Quality Improvement Processes and Approaches
“Form follows function,” a concept founded in the field of architecture, describes the importance of understanding what you want to do before you determine how you are going to do it. The premise behind the principle also applies when an organization is deciding what quality improvement process or approach to adopt. This section describes some of the many systems and processes that guide quality improvement efforts today.
These quality improvement approaches are derivatives and models of the ideas and theories developed by thought leaders and include:
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• PDCA/PDSA;
• Associates for Process Improvement’s (API) Model for Improvement;
• FOCUS PDCA;
• Baldrige Criteria;
• ISO 9000;
• Lean; and
• Six Sigma.
Shewhart Cycle/PDCA or PDSA Cycle
As discussed earlier, in the 1920s, Walter Shewhart developed the PDCA cycle used as the basis for planning and directing performance improvement efforts. Since the creation of the PDCA/PDSA cycle, most of the formally recognized performance improvement models have some basis or relation to this original quality improvement model.
Plan:
• Objective: What are you trying to accomplish? What is the goal?
• Questions and predictions: What do you think will happen?
• Plan to carry out the cycle: Who? What? When? Where?
Do:
• Educate and train staff.
• Carry out the plan (e.g., try out the change on a small scale).
• Document the problems and unexpected observations.
• Begin analysis of the data.
Study/Check:
• Assess the effect of the change and determine the level of success as compared to the goal/objective.
• Compare results to predictions.
• Summarize the lessons