Continuous quality improvement (CQI): solution to QA shortcomings?

In the previous decade, quality assurance gained prominence in an effort to ensure optimal medical care. Some experts, as Avedis Donabedian, M.D.--a leading scholar in the area of quality assessment--characterized its dimensions as falling into three categories: structure (inputs), process and outcome. Paul Ellwood, M.D., in 1988, further promoted the latter by introducing an "outcomes management" system. Now Berwick, James, O'Leary and others advocate the incorporation of certain industrial insights advocated by Deming, Juran and others to improve traditional QA Methods and develop a process of Continuous Quality Improvement (CQI). The goal is to have patients (and other customers) better served.