In response to national and local managed care pressures and reform initiatives, health care organizations are searching for ways to deliver more cost effective, higher-quality care, including the application of industrial quality control principles to the provision of health care services. Known as continuous quality improvement (CQJ) or total quality management (TQM), the hope is that widespread implementation of the underlying philosophy, approaches, and tools of CQl/TQM will result in an ability to both maintain and improve quality while controlling increases in costs.
The key elements in a combined definition of CQl/TQM include continuous improvement, customer focus, structured processes, and organization-wide participation. CQi tQM differs from the traditional quality assurance in many ways; among the most important is CQl/TQM's focus on understanding and improving underlying work processes and systems versus the traditional quality assurance emphasis on correcting after-the-fact errors of individuals.
Considerable interest has been expressed by hospital leaders in adopt ing the CQl/TQM approach. In fact, a recent national survey of 3,303