Continuous quality improvement. Concepts and applications for physician care.

There has been a growing interest by health care leaders in the continuous quality improvement method of quality management. This method uses measurements of quality "indicators" to initiate and drive organizational changes in a never-ending cycle of continuous improvement. Many discussions of the continuous quality improvement method have emphasized the organizational and attitudinal changes necessary to fully implement the model while deemphasizing the uses of measures of quality to guide improvement. In this article, we emphasize the concepts behind the measurement of quality that underlie the continuous quality improvement model and give examples of how these concepts can be immediately applied to guide improvement in the quality of physician care. ( JAMA . 1991;266:1817-1823)