REVIEWED BY PAUL F. CONLON, PharmD, JD
CQI and the Renovation of an American Health Care System
Sr. Mary Jean Ryan, FSM, and William P. Thompson
ASQC Quality Press, Milwaukee, 1997, 191 pp., $27 (hardcover)
This book is a recollection of an odyssey of an American healthcare system into the uncharted waters of continuous quality improvement (CQI). The text is not a CQI "how-to" manual; it is a compilation of valuable experiences relating to the assessment, introduction, and implementation of CQI principles and techniques.
The book explores CQI theory and teachings and does a reasonable job of relating theory and teaching to the practical experience of utilizing CQI tools and skills. The setting is the St. Louis based SSM Health Care System, which owns, operates, and manages 26 healthcare entities in six states. In 1989, despite being well positioned for the future, SSM leaders were concerned they were not seeing a constant striving for improvement. By 1990 they were ready for a new direction, and CQI theory and tools provided the compass.
The authors share their experiences as they prepared the system for a CQI transformation. The book reflects on laying the CQI foundation, identifying critical issues, understanding the role of leadership, infusing a customer focus into the organization, transforming the culture of patient care, integrating CQI principles into clinical and functional services, and measuring quality. Valuable lessons throughout the book will help those traveling the same CQI transformation road.
The authors review how they used flowcharting, cause-and-effect diagrams, Pareto charts, run charts, histograms, and other tools. They do not address the CQI principles of when and how to use these tools. Yet the information and experience provide insight into how one organization has made use of CQI teachings.
Reviewed by Paul F. Conlon, PharmD, JD, Director of Clinical Quality, Mercy Health Services, Farmington Hills, MI