CQI differs from QA because it is based on facts,
data, and specifications, rather than on standards
(Table 1). It is a method of management by fact,
which offers physicians data without blame. This
stimulates curiosity and learning, making CQI edu-cational rather than punitive. Its objective is to con-tinuously improve health care processes that will
lead to improved outcomes, rather than improve the
outcomes alone. Because CQI deals with process, its
focus is on the whole group, not just the statistical
tail, leading to the philosophy of quality being what
is “the best possible,” as opposed to QA’s philoso-phy of accepting what is “good enough.” The most
effective way to improve quality is to prevent quali-ty failures before they happen by building quality
into the process rather than adding it on at the end.
Adding quality on at the end is analogous to relying
on terminal inspection to improve manufactured
products as they come off an assembly line.