Tip of the week: Recognize differences between QA and QI

Quality improvement (QI) involves proactively evaluating an organization's functions, services, products, and processes on an ongoing basis and asking how each of those areas can improve. It focuses not only on improving the status quo, but also preventing certain problems from emerging in the future. QI encourages the constant pursuit of perfection and asserts that no level of error is acceptable.

Quality assurance (QA) is a more retrospective, data-driven, intermittent evaluation of an organization that assumes error and imperfections are inevitable and acceptable.

To create a culture that values the constant pursuit of perfection through QI, MECs must first start by adopting three basic principles:

1. We don't believe in scapegoats. About 93% of all quality problems are related to systems, while only 7% are related to individual performance. Improving the systems that govern your medical staff's actions will allow individuals to perform more effectively.
2. We believe in prevention. Although QI can be used to solve already existing problems, organizations should focus on finding and taking advantage of opportunities to improve-sometimes just because they can, not because they need to.
3. We don't ask you to change for the sake of changing. An organization's approach to QI should be data driven, and any changes should be monitored to ensure they are effective.

To learn more about creating and maintaining a QI culture, please see The Medical Executive Committee Handbook, Third Edition, by Mary J. Hoppa, MD, MBA; Albert L. Fritz, MHA; and Richard A. Sheff, MD.