Quality improvement involves a systematic approach to analyzing performance and improving it through waste reduction. The Model for Improvement provides a framework with three steps: 1) defining goals and metrics, 2) implementing Plan-Do-Check-Act cycles to test changes, 3) determining next steps. Quality improvement models have been applied in healthcare to enhance efficiency and outcomes. ISO 9001 also provides a framework to establish quality management systems and drive continuous quality improvement through certification.

1. Quality improvement
Calle Lindén
Sina Brödner
The Dinh Thi
Health care Improvement, 2012

2. Definition
• Quality Improvement is a formal approach to
the analysis of performance and systematic
efforts to improve it.
– (Department of Community and Family Medicine, 2005).
• The systematic approach to reduction or
elimination of waste, rework, and losses in
production process
– (International Organization for Standardization, 1994a)

3. The Model for improvement step 1
• Thinking phase
– What are we trying to accomplish?
– How will we know that a change is an
improvement?
– What change can we make that will result in
improvement?
(Langley, Nolan, Nolan, Norman & Provost, 1996).

4. The Model of improvement step 2
• Doing phase
– PDCA(PDSA) cycle
• Plan
– List tasks needed to set up the test of change
• Do
– Run the test and document what happened
• Check(Study)
– Describe the measured results and how they compared to
predictions
• Act
– Determine what the next PDSA cycle will be based on the
learning

5. The Model of improvement
What are we trying to
accomplish? Act Plan
How will we know that a
change is an PDCA cycle
improvement?
What change can we
make that will result in
improvement? Check Do
(Source: Langley, Nolan, Nolan, Norman & Provost, 1996. Visual: The authors to this presentation)

6. Examples of uses
• Applying the Model of improvement to various
health care problems can: Help improve efficiency
and health outcomes while incorporating many of
the resources already available to local health
departments.
(Harrison, et al., 2012)
• Nurse students that applied quality improvement
models could make an improvement in their study
habits or lifestyle.
(Kyrkjebö & Hanestad, 2002).

7. Motivation/Discussion
• “What really matters is whether or not a
hospital has a culture that supports quality
improvement work and an approach that
encourages flexible implementation.”
– (Shortell et al., 1995)

8. ISO 9001
• One of the largest framework for standards for
quality management systems
• Certificate for companies fulfilling several goals
about quality improvements
– Quality link between company, employees and customers
– Using quality models and the quality work is regularly
evaluated
• Can give the company
– Significant financial benefits
– A better quality
(International Organization for Standardization)

9. Methods
• Collection information about the concept through
brainstorming and googling
• Narrow it down to a couple more specific topics
• Search about the topics on google and PubMed using the
keywords: Quality, Improvement, Healthcare and The model
of improvement (Limit to full text and 10 years back in time).
• Present to most valuable find on the powerpoint

10. References
• Langley, G., Nolan, K., Nolan, T., Norman, C., Provost, L. (1996): The Improvement Guide: A Practical
Approach to Enhancing Organizational Performance.
• Kyrkjebö, J. & Hanestad, B. (2002). Personal improvement project in nursing education: learning
methods and tools for continuous quality improvement in nursing practice. Journal of Advanced
Nursing, 41, 88–98.
• Harrison, L., Shook, E., Harris, G., Lea, S., Cornett A., Randolph G., (2012). Applying the Model for
Improvement in a Local Health Department: Quality Improvement as an Effective Approach in
Navigating the Changing Landscape of Public Health Practice in Buncombe County, North Carolina.
Public Health Management Practice, 18, 19–26.
• Shortell, S., O'Brien J., Carman J., Foster, R., Hughes, E., Boerstler, H. & O'Connor, E. (1995).
Assessing the impact of continuous quality improvement/total quality management: concept
versus implementation. HSR: Health Services Research, 30, 377-401
• Department of Community and Family Medicine. (2005). Patient Safety. Retrieved 4 April 2012,
from: http://patientsafetyed.duhs.duke.edu/module_a/introduction/introduction.html
• International Organization for Standardization. (w.y.)b. ISO-9001. Retrieved 4 April 2012, from:
http://www.iso.org/iso/iso_catalogue/management_and_leadership_standards/quality_managem
ent/iso_9001_2008/faqs_on_iso_9001.htm.
• International Organization for Standardization. (w.y.)a. ISO-8402-1986. Retrieved 4 April 2012,
from: http://www.iso.org/iso/iso_catalogue/catalogue_ics/catalogue_detail_ics.htm?
csnumber=20115.