Quality Assurance or Quality Improvement: Whats the Difference

1
Quality Assurance or Quality ImprovementWhats
the Difference?

• Johanna Buck
• Title I Mental Health Providers
• Quality Learning Network
• October 3rd, 2005
• With thanks to Lori DeLorenzo, Susan Weigl and
  others

2
Quality Alphabet Soup
3
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

4
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.

5
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

6
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.

7
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. 

8
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.

9
Comparison of QA QI
10
QA versus QI
11
CQI vs. RESEARCH

• Research
• Aim gain new
• knowledge
• Methods
• Test blinded
• Eliminate bias
• More data, just in case
• Fixed hypotheses
• One large test

• Quality Improvement
• Aim make changes that result in improvement
• Methods
• Test observable
• Stable bias
• Just enough data
• Adaptation of the changes
• Sequential tests

12
What is Quality?

• Quality is a never-ending cycle of continuous
  improvement.

-Deming
13
Final Thought

• If you dont have time to do it right, when will
  you have time to do it over?