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Is your hospital ready for CQI?

The JCAHO's long-planned transition from quality assurance (QA) to continuous quality improvement (CQI) begins next month. That's when new standards of the 1992 Accreditation Manual for Hospitals take effect.

For 1992, the standards will require only that all hospital leaders--CEOs, administrators, medical, nursing, and other clinical directors--educate themselves on CQI methods. Then incrementally over the next several years, the standards will be revised until CQI is fully in place and required.

The '92 standards don't specify how hospital leaders must undertake education on CQI--a reading program or seminars are among the possibilities--but the surveyors will want to see evidence that they have done so or have concrete plans to do so next year.

Are hospitals primed for CQI? Well, their QA people certainly are, according to a new study reported in the Aug. 5 issue of Hospitals magazine. Of 351 hospital QA professionals surveyed by the American Society for Quality Control (ASQC), 95% were familiar with CQI and 70% reported that some quality improvement activities are occurring in their hospitals beyond traditional QA (see Figure I). Of that 70%, almost half said they were in charge of such quality activities.

Although many hospitals were at the beginning of the CQI process, 24% of the respondents said that their facilities had achieved significant results and 18% were very pleased with the results.

The Joint Commission borrowed CQI, which is also called total quality management (TQM), from industry, where it was developed by management gurus W. Edwards Deming, Joseph Juran, and Philip Crosby. The concept has been effective in both small and large companies, but it takes an average of two-and-a-half years for positive results to show.

What happens to QA? The introduction to the 1992 Accreditation Manual puts it this way: "Principles of [CQI] incorporate the strengths of quality assurance as it is currently practiced, while broadening its scope, refining its approach to assessing and improving care, and dispensing with the negative connotations sometimes associated with it. In moving toward [CQI], the Joint Commission wants health care organizations to build on the strengths of their present quality assurance mechanisms. These mechanisms and the persons who have established them constitute a substantial foundation from which to launch the transition to continuous quality improvement."

Two articles in this issue of MLO are related to the JCAHO's new direction. One is "How to Earn Perfect Scores from Your JCAHO Surveyor," and the other, "Achieving the Customer-Oriented Laboratory." I think you will find both very helpful in adapting to the CQI era.
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Copyright 1991 Gale, Cengage Learning. All rights reserved.

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Title Annotation:continuous quality improvement
Author:Fitzgibbon, Robert J.
Publication:Medical Laboratory Observer
Article Type:Editorial
Date:Dec 1, 1991
Previous Article:Pulling the plug on an LIS project that failed.
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