This document discusses strategies for building a culture of continuous quality improvement (CQI) in institutions. It defines CQI as a philosophical approach that focuses on continuously improving services to better meet customer needs. The key aspects of CQI include defining quality as meeting customer expectations, focusing on improving processes rather than individuals, and using objective data to analyze and improve processes. The document outlines the CQI cycle and assumptions, provides examples of institutions using CQI, and discusses establishing measurable outcomes and ensuring communication and evaluation are part of the CQI process.