Reinvigorating stalled CQI efforts through physician involvement

Continuous quality improvement (CQI), loosely synonymous with total quality management (TQM), was designed for the comparatively simple world of industry. Now that the gurus of CQI have attempted--originally with full support of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)--to apply the industrial CQI model to hospitals, they've noticed something: The model doesn't work, and hospital CQI programs are faltering enough to persuade the Joint Commission to scale back its CQI accreditation requirements. One major shortcoming behind the performance to date of CQI in hospitals: Physicians don't fit into the industrial model of CQI. Physicians are too important, and too many programs are stalled, to continue to implement CQI as though physicians don't exist. The techniques described here should help to reinvigorate faltering programs, giving hospital management a chance to "do it right the second time."