Department deployment: integrating quality improvement into day-to-day management

Despite the time and resources that The George Washington University Medical Center (GWUMC) put into training and forming QI teams, QI staff found that CQI was not being used to carry out critical day-to-day departmental functions. In other words, CQI didn't affect the way staff did "real work." In response, the medical center developed an approach that integrates CQI with departmental leadership, structure, culture, and work routine. With the help of a coach, willing departments at GWUMC choose from a series of 155 activities that they complete at their own pace (eg, setting departmental CQI goals, developing a departmental mission). The department deployment process moves staff through three levels of increasing sophistication and maturity with CQI methods: awareness, understanding, and bonding. It is intended to make quality a habit for staff, or a part of the organizational mind set, rather than an isolated "project." This article will describe how the department deployment approach was developed, its philosophical underpinnings, and its methodology and tools. Then, an example will illustrate how one hospital department--social work and utilization case management--successfully used this approach.