Continuous quality improvement and health promotion: can CQI lead to better outcomes?

Abstract

Canadian health promotion organizations currently face two pressures. First, is the desire of health promotion organizations to seek methods which will help achieve health promotion goals. Second, external funders are increasingly likely to require that health promotion organizations adopt ‘quality’ procedures, such as Continuous Quality Improvement (CQI). This paper explores a set of questions that assess the potential benefits of CQI with respect to health promotion organizations. These questions include: Is the philosophy of CQI compatible with health promotion principles, values and beliefs? Is CQI methodology and approach applicable to health promotion? If there are no irresolvable conflicts between CQI and health promotion, will implementing CQI processes improve health promotion practice? In addition, the paper highlights several issues that health promotion needs to address before adopting CQI, including: the meaning and relevance of concepts such as ‘customer’ and ‘customer satisfaction’, within the context of health promotion; and the heavy emphasis that CQI places on data that are measurable and quantifiable. While further exploration and documentation are required before definitive resolution of these issues, a preliminary overview indicates that CQI, with some modifications, is compatible with health promotion in at least some circumstances and that, if these modifications are implemented, CQI could help health promotion achieve its goals.