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Common Questions about Continuous Quality Improvement (CQI)

Posted by Kade Jansson

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May 5, 2017 6:05:00 AM

Excellence - Business Background. Golden Compass Needle on a Black Field Pointing to the Word "Excellence". 3D Render..jpegWe’ve noticed a theme to many of the conversations that we’ve been having with clients and at the events we’ve attended lately. Lots of folks have questions about the concept of Continuous Quality Improvement or CQI for short. We’ve put together some answers to the questions we are asked most often and even a few that people don’t ask, but they really should.

Is Continuous Quality Improvement Just for Manufacturing Companies?

This comes up quite a bit with many of the methodologies that our improvement management software helps customers manage. The literature around CQI and other techniques is full of references to manufacturing because many of the methods got their start in that sector. Approaches like Lean, Six Sigma, TQM and others were first applied in auto manufacturing and then spread to factories that made just about anything.

But other industries began to take note of the success of improvement efforts in manufacturing and realized that the core principles of CQI can be applied to almost any sector. We now see the approach being applied in healthcare, higher education, construction, software development, transportation and almost any industry you can name. This is because all of them are made up of a series of processes that can be broken down, analyzed and made better.

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What is Quality?

This is a question that we don’t hear very often, but we wish more people would ask.  It is easy to understand quality in terms of manufacturing where components and products are produced and defects are evident, but quality applies to the output of every process in any organization. Quality means accurate data entry, it means adequately stocked exam rooms, it means making payments to vendors on time, it means providing effective customer service. Every person from the front desk attendant to the CEO is responsible for quality outputs that have an impact on every stakeholder including customers, investors, employees, and the community.


What are the Core Principles of Continuous Quality Improvement?

Each organization shapes their approach to CQI, but there are some guiding tenets shared by most.

  • Quality means meeting or exceeding the expectations of internal and external customers.
  • Most problems are found in processes, not in people. CQI is about seeking solutions and getting the best outcome, not blaming people for problems.
  • Standardization is necessary to eliminate variation in outcomes. Processes are performed to the standard until opportunities for improvement are identified and implemented.
  • Improvement can be achieved through incremental changes implemented using the scientific method.
  • Improvement should be part of the culture of the organization and a natural part of the way people do their jobs every day.


How is CQI Applied?

The basic steps for implementing an improvement using the CQI philosophy are as follows:

  • Select a team that has knowledge of the process or system to be improved. People who do the work should be on the team, along with other stakeholders and subject matter experts.
  • Define the problem and its impact.
  • Document the current process.
  • Document the needs of the people who will receive the process output.
  • Define success and determine how it will be measured.
  • Brainstorm potential improvements.
  • Implement selected changes.
  • Collect data related to the success metrics.
  • Refine changes.
  • Adjust the standard if the changes produced the desired results. If not, repeat the process.


What Tools and Techniques are Useful for Continuous Quality Improvement?

There are a variety of tools and techniques that can help streamline the path to improvement and keep it top of mind. They include:

Improvement Management Software: A central system for documenting improvement efforts and collecting ideas for positive change helps improvement work gain momentum. It provides a standard way to measure the impact of improvement and enables collaboration. The most effective solutions have built-in workflow with alerts and notifications to accelerate the pace of change.

Standard Work: Standard work (sometimes called Standardized work) is the documentation of the best practices for any process or task. Standard work forms the baseline for improvement.

PDSA: PDSA stands for Plan, Do, Study, Act. It is also known as the Deming Cycle. An opportunity for improvement progresses through this cycle with documentation occurring at every step. Once the cycle is complete, it begins again with a new plan for improvement.

Value Stream Mapping (VSM): Value Stream Mapping is a CQI method for documenting and analyzing every step of the process that takes a service or product from its request to its delivery to the customer. It helps identify opportunities to eliminate waste and improve the quality of outputs from any type of process.

Catchball: Catchball is a practice in which an idea is generated by one person, often, but not always, a manager. That person passes the idea to someone else for feedback and action. The idea is passed back and forth, up and down, and between as many people as necessary for it to turn into a completed improvement.


Continuous Quality Improvement is something that every leader would agree is a laudable goal. But it doesn’t happen on accident. Successful organizations apply the principles and techniques with purpose and commitment. If you have questions about the approach that we did not answer here, please feel free to reach out. We’re always happy to chat about it.

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Topics: Daily Improvement, Quality, Spread Continuous Improvement, Improvement Methodology

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