Quality Improvement in the Integrated Health Care Setting

Abstract

W. Edwards Deming (1990–1993) is widely recognized as the originator of the quality improvement movement. Although the movement began with his early work in the 1940s in the United States, the roots of the movement are perhaps more firmly planted in his work in the post-war reconstruction of Japan’s industry (Aguayo, 1990). With the later adoption of Deming’s principles by US-based automobile manufacturers, the movement had finally “come home” and has proliferated in the United States ever since (Gabor, 1990). As the consumer base has become more educated, active, and demanding, indicators of quality across a variety of fields have become widely known. Examples include the JD Power and Associates1quality awards in the automotive industry, the Joint Commission on Accreditation of Healthcare Organizations2for hospitals and other health care organizations; and the Malcolm Baldrige National Quality Award3in the business, education, health care, and nonprofit arenas. Consumers have even created grassroots movements to establish minimum service delivery standards where none previously existed, like the “Flyers Bill of Rights” 4.