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Smarter Care: Embedding CQI in community-based health and social services

Smarter Care: Embedding CQI in community-based health and social services

Continuous Quality Improvement

Continuous Quality Improvement (CQI) is defined as "a structured organisational process for involving personnel in planning and executing a continuous stream of improvements […] in order to provide quality health care that meets or exceeds customer expectations" (Sollecito & Johnson 2013). CQI operates at the local level of the health system to ensure quality access, care and outcomes for clients. It sits under Clinical Governance which is one of three mechanisms for quality in health care (see figure below). 

                                            

In order to sustainably embed CQI in client care you need an enabling organisational environment – without this, efforts will be largely futile. Based on the literature the following questions can be addressed:

Organisational requirements for CQI

Organisational requirements (OR) are the structures and processes an organisation needs to have in place in order to sustainably embed CQI in client care in everyday practice. There are 13 ORs, shown on the blocks below. A description is provided for each: preamble, definition and 'What to look for'. Click on the 'References' block to find the sources cited in these descriptions. 

'What to look for' are checklists that stakeholders can use as a guide when defining their CQI issues or problems, developing and testing their strategies and implementing their service redesign. These checklists are not intended to be exhaustive, and features on the checklist may be present in an organisation to varying degrees.

The requirements are inter-related — for example, having an effective CQI Lead role relates to both OR2 Leadership and OR6 Workforce.

How to use this tool

Three journal articles reporting CQI interventions involving community-based settings are used to illustrate the features of the ORs. The synopses of the articles are organised around the structure of the Plan-Do-Study-Act cycle. You can preview all three journal abstracts and synopses by clicking on the 'Journal abstracts and synopses' block below. Clicking on the title, which is highlighted in blue, will take you to the full published article.

Click on the OR you are interested in and review its description. 

One or more of the journal synopses that illustrate a feature of this OR will be listed at the end of the description. Click on the + sign to the right of the abstract heading to open the 'accordion' format, click on the - sign to close. Open each one and reread in order to:

  1. Identify and briefly reflect on one feature of this OR that is clearly evident from this study. One example will be shown when you click 'show answer'.
  2. Identify one other feature of this OR that you think might be implied by the study.

Acknowledgment

This material was developed by Dr Beverly Sibthorpe and Dr Sanchia Shibasaki, and builds on earlier research and development work by the authors and Dr Karen Gardner, including for a national CQI framework in Aboriginal and Torres Strait Islander primary health care for The Lowitja Institute.

Copyright

                                                                                                                                                                                                                                          This work is copyright. Apart from any use permitted under the Copyright Act 1968, no part may be reproduced by any process, nor may any other exclusive right be exercised, without the permission from the SenseMakers for Smarter Care Partnership, P O Box 7083, Holland Park, Q 4121, Australia.