Use of continuous quality improvement methodology to solve service delivery problems in a health care environment

Abstract

The Continuous Quality Improvement (CQI) process, a critical part of the Total Quality Management (TQM) philosophy, is designed to find problems in a manufacturing process and make corrections using small incremental changes. These changes are monitored closely to see if they have the desired effect on the process or if additional changes are necessary. This paper follows the actual implementation of this process in a health care service delivery system and discusses the various stages. TQM history is discussed in the introduction along with the change in the management culture necessary to establish and sustain a focused effort toward this end. The FADE or Focus, Analyze, Decide, and Execute method of CQI is being used as a basis for this process. This method is used at the hospital as their main tool for implementing the continuous process improvement. The process that is causing customer dissatisfaction and is the focus of this paper is the Patient Discharge Process. This process is initiated to end a patient's stay at the hospital. The process is used to give the patient necessary information, instruction and supplies needed for the continuation of care wherever he or she may go. The present focus is on the length of time that the discharge process takes. At the present time too many patients believe it requires too much time. The monitoring phase is what makes this process continuous. All of the changes that are implemented are monitored and adjustments are made when and where new problems are identified. The CQI process must be ongoing so it is necessary that it be supported by top level management, which must make the necessary resources and time available. Without this support, this process becomes intermittent and ineffective.