Continuous Quality

Improvement (CQI)
By: Kayla Guanella

Quality
Health and Human Services organizations focus and
direction are provided by the quality needs and preferences
of the consumer
First recorded was in France
1793 National Convention of the French Revolution
1 patient to a bed

America
1918 (1946) American College of Surgeons developed a page of
standards to be implemented into hospitals
1951 Joint Commission on Accreditation of Hospitals (JCAH, now
JCAHO) adopted standards
1966 Commission on Accreditation of Rehabilitation Facilities
(CARF)
Independent by 1971

Quality Cont
Has its own definition, like beauty, its in
the eye of the beholder
More of a standard

In the end quality is defined by consumers

JCAHO (1990s)
Objective was to provide quality health care in
appropriate settings at an economical cost
Late 1990s shift from process and structure to
performance and outcomes
By 2004 safety become an important dimension
1950s began with adequate client care to 21st
century using EBP

What is CQI?
The process used to improve quality and
performance
Mid 1980s started to blend and overlap
previous programs: quality assurance and
risk management
Teamwork is the core
Focuses on crossing departmental and
discipline lines
Allows employees to relate jobs to department
and organization mission

Quality Accreditation Bodies

CARF
Looks at the quality

National Committee for Quality Assuranc

e (NCQA)
Improving healthcare quality
1990

Centers for Medicare and Medicaid Servic

es (CMS)
1977
Quality care at lower costs
Quality of insurance

What is CQI?
Based off of the definition.
Do or have you seen this executed in your
current work place? What have you
witnessed?
What do you know about CQI?

CQI Customers
Internal and external
Internal
Professionals and employees and
departments or units that provide
services

External
Patients, families and friends of
patients, regulatory agents, and third
party payers

The Deming Cycle

Case Study Get together in partners or do by yourself

5-10 minutes
You are at your internship placement and you
realize there has been an ongoing problem
within the department. There is a lack of
communication which is decreasing the
quality of service to participants in the
programs TRSs arent running the correct
programs on the correct days or times. There
is a calendar but they department doesnt
utilize it to the fullest.
Use the Deming Cycle to brainstorm and
come up with a probable solution

QA and CQI in TR

Quality Assurance
Process of ongoing monitoring and evaluation
of services and implementing mechanisms that
ensure standards are met
Looks at the structure, process, and outcomes

Continuous Quality Improvement

Blends with QA, it becomes the baseline
Doesnt look simply at what is good now but
how it can be improved
Attention becomes focused on the CONSUMER,
but also looks at the structure, process, and
outcomes like QA

QA and CQI in TR Cont

Consumer
TR dept consumer when requesting medical files for patients

Structure
Settings and resources
Facilities, equipment, staff, finances, management,
organizational arrangement, legal authority, treatment plan

Process
Tells us how and what the TR professional will do
How consumers achieve outcomes is important

Outcome
Ultimate goal of the TR service

Tools

How?
Useful Tools
Lean and six sigma
Change to create
work flows
7 principles
Overproduction
Waiting time in
queue
Transportation
Nonvalueadding
processes
Inventory
Motion
Costs of quality,
scrap, rework
and inspection

CQI
After learning about CQI and accreditations
and the process
How can you utilize this or help your
profession utilize this in your future?

References
About CARF. (2015). Retrieved November 9, 2015, from http://www.carf.org/home/
About CMS. (2015). Retrieved November 9, 2015, from https://www.cms.gov/About-CMS/AboutCMS.html
About NCQA. (2015). Retrieved November 9, 2015, from

http://www.ncqa.org/AboutNCQA.aspx

Carter, M., & Morrow, G. (2006). Quality Service Management. In Effective management in
therapeutic recreation service (2nd ed.). State College, Pa.: Venture Pub.
Continuous Quality Improvement Strategies to Optimize Your Practice. (2013, April 30).
Retrieved November 9, 2015, from
https://www.healthit.gov/sites/default/files/nlc_continuousqualityimprovementprimer.pdf
The Joint Commission. (2015). Retrieved November 9, 2015, from
http://www.jointcommission.org/about_us/about_the_joint_commission_main .aspx