Continuous Quality Improvement (CQI) in healthcare refers to a structured quality management process that necessitates the active involvement of personnel in both planning and execution of policies aimed at the improvement of experience and outcomes of care (Sollecito, & Johnson, 2011). The existence of the quality chasm in healthcare calls for the revision of healthcare process with the goal of finding improvement opportunities (HenryFordTV, 2011). The aim of this paper is to discuss the importance of a strong understanding of theoretical perspectives in healthcare and the availability of resources to develop efficient CQI strategies.
Theory and Resources
Current CQI efforts reflect in part the failure to achieve sustained improvements in the quality of healthcare. In order to overcome limitations to the achievement of desired provider-level and patient-level outcomes, it is necessary to utilize available resources and nursing knowledge. It has to do with the fact that the reduction of the number of medical errors that contribute to the low quality of care, hinges on the successful execution of nursing tasks under a wide-range of conditions (McFadden, Stock, & Gowen, 2014). To this end, nursing practitioners should have a strong understanding of the theory and key concepts, which can strengthen both their current practices and improvement efforts. Initiatives to improve healthcare quality require the use of monetary and non-monetary resources to develop interventions, identify barriers to their implementations, overcome barriers, and learn from those efforts (Davidoff, Dixon-Woods, Leviton, & Michie, 2015). Therefore, to safeguard best practices, healthcare practitioners should have a deep understanding of the theory and have access to sufficient resources.
Business Case for CQI
A business case for improvement interventions in healthcare is based on the assumption that an organization can obtain a financial return on its investment in CQI within a reasonable time frame (Sollecito, & Johnson, 2011). To defend the business case in the organizational setting, nurses should rely on the two-pronged approach. On the one hand, it is necessary to draw superiors’ attention to the economic dimension of CQI, which can be manifested in direct cost reductions. On the other hand, by realizing comprehensive CQI initiatives, it is possible to avoid losses (Drummond, Sculpher, Claxton, Stoddart, & Torrance, 2015).
To strengthen the business case for CQI, it is necessary to emphasize that greater diffusion of quality improvement efforts in healthcare can substantially lower medical errors and malpractice litigation expenses. According to Saber-Tehrani et al. (2013), the sum of error-related payments over the period of 25 years is $38.8 billion when adjusted for inflation. The costliest reasons for malpractice allegations are a failure to diagnose and wrong diagnosis, which account for almost 60 percent of total payments (Saber-Tehrani et al., 2013). Furthermore, the occurrence rate of these types of allegations is the highest. It follows that by taking full advantage of the theory and available resources, it is possible to ensure that a sizable portion of medical errors disappears. The importance of this point is underscored by the fact that the costliest errors occur in the elderly population, which is especially vulnerable. Specifically, two types of preventable errors that can be targeted by CQI initiatives are post-operative infections and pressure ulcers (Mallow, Pandya, Horblyuk, & Kaplan, 2013).
The paper has discussed the importance of the application of the theory, key concepts, and available resources in the development of CQI strategies. It has been argued that CQI initiatives should be guided by a strong understanding of theoretical underpinnings of the nursing practice. The paper has also presented the business case for CQI, the core of which is the economic dimension of the quality improvement efforts.
Davidoff, F., Dixon-Woods, M., Leviton, L., & Michie, S. (2015). Demystifying theory and its use in improvement. BMJ, 24, 228-238.
Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes (4th ed.). Oxford, England: Oxford University Press.
HenryFordTV. (2011). Minds of medicine: Do no harm – safety & quality no harm campaign [Video file]. Web.
Mallow, P. J., Pandya, B., Horblyuk, R., & Kaplan, H. S. (2013). Prevalence and cost of hospital medical errors in the general and elderly United States populations. Journal of Medical Economics, 16(2), 1367-1378.
McFadden, K. L., Stock, G. N., & Gowen, C. R. (2014). Leadership, safety climate, and continuous quality improvement: Impact on process quality and patient safety. Health Care Management Reviews, 40(1), 1-11.
Saber-Tehrani, A. S., Lee, H., Mathews, S. C., Shore, A., Makary, M., Pronovost, P. J., & Newman-Toker, D. E. (2013). 25-year summary of US malpractice claims for diagnostic errors 1986-2010: An analysis from the National Practitioner Data Bank. BMJ Quality & Safety, 24, 228-238.
Sollecito, W. A., & Johnson, J. K. (2011). McLaughlin and Kaluzny’s Continuous Quality Improvement in health care (4th ed.). Burlington, MA: Jones & Bartlett Learning.