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Where’s Quality in the Alphabet Soup?. Lori DeLorenzo, RN, MSN ADHC Quality Learning Network September 16, 2005. Quality Alphabet Soup. Quality Assurance vs. Quality Control.

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Where s quality in the alphabet soup

Where’s Quality in the Alphabet Soup?

Lori DeLorenzo, RN, MSN

ADHC Quality Learning Network

September 16, 2005

Quality assurance vs quality control
Quality Assurance vs. Quality Control

Quality assurance and quality control are often used interchangeably to refer to ways of ensuring the quality of a service or product.

The terms, however, have different meanings.

Quality assurance
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
Examples of Quality Assurance Activities

  • Annual infection control and safety training

  • Review medication closet for outdated meds

  • Review emergency chart once a week for supplies and outdated meds

    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 control
Quality Control

“The observation techniques and activities used to fulfill requirements for quality.”

American Society for Quality

Examples of quality control
Examples of Quality Control

  • Infection control training sign-in sheets cross-referenced with staff roster

  • Review sheet of emergency cart that ensures stocked supplies and meds

  • Direct observation of counseling session, e.g. provision of key elements of post-test HIV counseling

Quality improvement
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
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
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 cqi1

  • 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.

Cqi vs research

Quality Improvement

Aim: make changes that result in improvement


Test observable

Stable bias

Just enough data

Adaptation of the changes

Sequential tests


Aim: gain new



Test blinded

Eliminate bias

More data, just in case

Fixed hypotheses

One large test


What is quality
What is Quality?

Quality is a never-ending cycle of continuous improvement.


Final thought
Final Thought…

If you don’t have time to do it right, when will you have time to do it over?