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1.2 Quality Improvement in Healthcare

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Quality improvement (QI) is an integral component of the healthcare delivery landscape, necessitated by cost escalation and the drive to achieve better individual and population health outcomes. Government and nongovernment organizations at all levels provide resources, strategies, and mandates to achieve global, national, and local health goals. The United States has adopted a national strategy for healthcare quality improvement with three aims: better care, healthy people/healthy communities, and affordable care (Agency for Healthcare Research and Quality 2017). The World Health Organization articulates quality dimensions of effectiveness, efficiency, accessibility, patient‐centered, equity, and safety that are applicable to all countries for improving health systems (World Health Organization 2006).

Quality improvement can be defined as the use of a continuous and systematic approach to achieve measurable improvement in healthcare delivery and individual and population health outcomes. Adopting a culture of quality improvement in a healthcare organization can lead to increased efficiency and productivity, better patient and employee satisfaction, the ability to retain and attract high‐performing employees, better clinical outcomes, and reduced errors, risks, and costs. Quality improvement should be practiced continuously at all levels and functions of an organization. Additional information on quality improvement can be found at the websites of the American Society for Quality and the Institute for Healthcare Improvement.

There are a number of related activities found in healthcare delivery (and beyond) that differ from quality improvement. Quality assurance is a periodic, systematic review of a process to identify and correct errors and ascertain whether standards are being met. Quality improvement and quality assurance both focus on existing systems and processes, with quality improvement programs being driven from within the organization and quality assurance being driven by external organizations (e.g. government and accrediting agencies). Research activity can be found in healthcare organizations, but the emphasis is on attaining knowledge that supports the development of new interventions, products, systems, and processes. Quality improvement, quality assurance, and research share many methodologies and tools; the statistical tools presented in this book focus on quality improvement applications, but can also be used in research and quality assurance.

Improving Health Care Quality

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