CONTINUOUS QUALITY

IMPROVEMENT

By
Feyera Gebissa
(B.PHARM,MHA)
Oct 16,2014
 Outline of presentation
Definition Of Continuous Quality
Improvement(CQI)
Components of CQI
Model For Improvement
Structural requirements for CQI
Exercises on CQI
 Objectives of presentations
To gain an understanding of what quality
improvement is
To describe Model of Quality Improvement and
PDSA cycle
To know how to apply PDSA to solve problems
we are practically facing to bring about
improvement .
 Background
Continuous Quality Improvement:-

An ongoing, organization wide framework to monitor

and evaluate all activities and outputs to continuously
improve processes and outcome of care(AHA).

Application of data-based management principles to the

clinical & administrative processes that produce patient
care.
JUSH adopted a model of CQI developed by New York State
Department of Health(the HIVQUAL model).
 Background
These includes two components

1. Performance measurement
is method by which all departments in one
organization will measure their performances on
quality of care by indicators selected at national
and local level
Is bases for quality improvement
 Quality improve
2. Quality improvement:
Refers primarily to clinical settings (Continuous,
prospective, learning)

A way to examine existing healthcare processes

to rework these processes based on finding
from performance measurement.
scientific & administrative knowledge
relevant data gathering & analyses methodology.
 Quality improve
During this phase teams will be formed that:

Analyses root cause of gaps in quality

Identify potential solutions

Test effectiveness of identified solutions

Take actions based on lesson learnt from

previous steps
 Quality improve
This step will be fully implemented by using
Deming's improvement cycle(PDSA cycle)

PDSA allow quality improvement teams to

systematically investigate and intervene
problems in quality of health services
 PDSA(plan,do,study & Act)

Enables rapid testing and learning

Allows for incremental testing

Instead of spending weeks or months planning

out a comprehensive change, then putting it
into practice only to find that it is
fundamentally defective
 PDSA(plan,do,study & Act)
Can aid you in:
Developing a change
Testing a change
Implementing a change
All improvement will require change, but not
all change will result in improvement.
PDSA(plan,do,study & Act)
What are we trying to accomplish?

How will we know that a change is

an improvement?

What change can we make that will

result in improvement?

ACT PLAN

STUDY DO

MODEL FOR IMPROVEMENT

Importance of team Work
 Successful Team work

I N N O V A I O N
S U C S S S
E V A L U T I O N
D E V E L O E N T
G R O T H
S L U T I O N
P R O G E S S
M A R E T I N G
 PDSA (plan,do,study and act)

designing a change thought to

bring about improvement
Preparing implementation of the
change
A.Plan Link Quality measurement with
quality improvement
 PDSA Quality
(plan,do,study and act)
improve
setting objectives for improvement
Identify root causes of problems in
quality of care
Exploring possible solutions to
A.Plan: address the identified root causes
Prioritize possible solutions
Involves
Planning implementation of
selected solutions(by who, what,
where, when)
Plan for data collection
 PDSA (plan,do,study and act)

B. Do
Implement planned changes on small scale

The team document problem and unexpected

positive and negative consequences resulting
from implementing of intervention

Begin analysis
 PDSA (plan,do,study and act)
C. Study
complete analysis of data
Check whether planned improvement goal
achieved
Summarize what was learned
Inform for the need of implementing changes
at large scale
 PDSA (plan,do,study and act)
D. Act
What changes are to be made?
Based of finding from the study phases, quality
improvement team need to make decision:
To expand effective changes and
To modify those in need of improvement

Next cycle?
 PDSA (plan,do,study and act)

Much can be learnt

from a failed test
ACT PLAN

STUDY DO
ACT PLAN
PDSA

PDSA
STUDY DO

ACT PLAN
PDSA

STUDY DO
PDSA

PDSA
 Infrastructure for CQI

Refers to Human resources, guidelines, facilities

required for implementation of CQI

Often included in Process Measures

Assignment
 Exercises
% of outpatient not seen on the same day
,147 in number, but it should be
% of emergency room attendances with length
of stay >24 hrs is 6.6%