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Quality Assurance or Quality Improvement:What’s the Difference? Johanna Buck* Title I Mental Health Providers Quality Learning Network October 3rd, 2005 *With thanks to Lori DeLorenzo, Susan Weigl and others
Quality Assurance “The planned and systematic activities implemented in a quality system so that quality requirements for a product or service will be fulfilled.” American Society for Quality
Examples of Quality Assurance Activities • Annual child abuse and domestic violence training • Chart review for patient's signature on consent forms • Utilization Review process Activities that are based on public health standards, licensing standards, institutional policies, etc. Can help identify a problem, but are more often used to comply with the standards.
Quality Improvement “Continuous improvement is an ongoing effort to improve products, services or processes. These efforts can seek “incremental” improvement over time or “breakthrough” improvement all at once.” American Society for Quality
Goals of Quality Improvement • The goals of QI are to understand the process, reduce the unintended variation in care, eliminate errors, remove unnecessary steps, and improve communication and accountability. • The process is designed toward outcomes. Quality improvement depends on measurement.
Core Concepts of CQI • Quality is defined as meeting and/or exceeding the expectations of our customers. • Success is achieved through meeting the needs of those we serve. • Most problems are found in processes, not in people. CQI does not seek to blame, but rather to improve processes.
CORE CONCEPTS OF CQI • Unintended variation in processes can lead to unwanted variation in outcomes, and therefore we seek to reduce or eliminate unwanted variation. • It is possible to achieve continual improvement through small, incremental changes using the scientific method. • Continuous improvement is most effective when it becomes a natural part of the way everyday work is done.
Quality Improvement Aim: make changes that result in improvement Methods: Test observable Stable bias Just enough data Adaptation of the changes Sequential tests Research Aim: gain new knowledge Methods: Test blinded Eliminate bias More data, just in case Fixed hypotheses One large test CQI vs. RESEARCH
What is Quality? Quality is a never-ending cycle of continuous improvement. -Deming
Final Thought… If you don’t have time to do it right, when will you have time to do it over?