The search for value: a quality improvement cycle linking process, outcomes, and patient satisfaction

American industry has been implementing continuous quality improvement (CQI) for several years. The business community and accrediting organizations are applying pressure to health care organizations to implement CQI to assure the delivery of cost-effective, quality health care services. In their rush to embrace the demands of industry, health care organizations must realize that many within their ranks long ago adopted the philosophy of CQI without calling it by name. The key is to adapt the concepts of CQI to existing quality improvement efforts rather than simply following a new recipe. By looking primarily at hospital systems like administration and finance, health care organizations may not be significantly addressing the clinical system. Consumers, however, want patient care to be addressed immediately. The author reflects on his experience that process improvement, not personnel change, is the key to successes in health care management.