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Continuous Quality Improvement/Plan, Do, Check, Act Cycle

Continuous Quality Improvement (CQI) developed in industry during the 1940s in an effort to train workers to consistently evaluate and monitor the quality of production, as well as to involve the whole workplace in the progress of the institution. This model focuses on a team approach, rewarding the successes that come from team efforts.

The Plan, Do, Check, Act (PDCA) Cycle is a modification of CQI that has been expanded and applied successfully around the world in many different industries and businesses, including health care. 

The CQI and PDCA models provide workers and managers with a unique way of thinking about their roles within the organization. W. Edwards Deming was instrumental in expanding CQI/PDCA and taught workers to collect and use their own data about the processes and production in which they were involved, referred to as ‘statistical quality control’.1 He emphasized improving the processes within an entire system, rather than blaming individuals or focusing on their faults. Deming taught that efficiency could be improved by including everyone involved, even the customer, to delineate and assess the process, collect data and elucidate a problem, develop and plan an improvement, make the change, and re-evaluate to see if the expected results were achieved. 

When applied in health care settings, the CQI model and the PDCA Cycle involve all participants, including those who would implement the program, those who would receive the services, and those who would evaluate the success or failure of the program. This helps to ensure that the final product, program or service, is relevant and culturally appropriate for the community being served.

CQI is a process-oriented approach delineated more specifically by the steps of the PDCA Cycle. The steps, known as the CQI/PDCA cycle, are as follows:
Plan- Study a particular process—what changes might be desirable? Organize the          appropriate team. What data are available? Are new observations needed? If yes,          plan a change or test. Decide how you will use the observations.
Do- Search for data on hand or carry out the change or test, preferably on a small
         scale, to collect the data.
Check- Observe or study the effects of the change or test. What did you learn?
Act- Repeat Step 1, with this new knowledge. Repeat Step 2, and onward.


The CQI-PDCA model can be represented visually as follows:

THE PDCA CYCLE OF CQI

References

1Walton, M. The Deming Management Method. Putnam, 1986.

2Continuous Quality Improvement Server, http://deming.eng.clemson.edu