Continuous Quality Improvement

The Quality Book of Tools is best used with a continuous quality improvement (CQI) approach. CQI is the process of collecting data about a particular practice or service to benchmark performance, tracking and validating indicators that affect outcomes, and recognizing problems in processes of care and practice management. CQI is a culture of never-ending improvement of the whole system as part of normal daily activity, continually striving to act according to the best available knowledge. The assumption behind quality measurement is that unless we learn something about what we are doing, we are unlikely to know that it needs improving or how to improve it. Measurement alone, however, is not useful – it must be associated with a CQI approach.

A number of models and cycles can be used to apply CQI on an ongoing basis. One of the most commonly used approaches that has been successful in family practice settings is the Plan-Do-Study-Act (PDSA) cycle.

PDSA enables testing of changes on a small scale to determine if they are beneficial. Each small improvement builds knowledge and confidence and enables continued reflection on the quality of the practice.