Quality Management and Quality Improvement Programs

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Image by Gerd Altmann from Pixabay

This section, while clarifying the difference between quality assurance and quality improvement, reinforces the importance of comprehensive quality management programs and provides examples about how they can be developed, implemented, and evaluated in order to achieve the best possible outcomes. Provided are examples of the tools and frameworks used in quality management programs.


At the end of this section, the learner will have a deeper understanding of

  • Quality Assurance and Quality Improvement
  • Concepts related to quality management, quality improvement and the structures and processes that influence quality outcomes
  • Models, frameworks, and methodologies related to quality management, quality improvement
  • The tools that support Quality Improvement and the development of Quality Improvement Plans.
  • Indicator development and measurement and evaluation.
  • The legislative requirements regarding Quality Improvement in health care


Lecture Video: Quality Management and Quality Improvement Programs (24:19)

Slides: Quality Management and Quality Improvement Programs


Activity #1

If possible, identify 1 or 2 Quality Assurance activities, and 1 or 2 Quality Improvement initiatives in your work environment. Have they resulted in changes and improvements?


Activity #2

This video provides a summary of the evolution of Quality Improvement (QI) and an overview of the QI process, providing examples that demonstrate the value of commitment to improvement, systems thinking, innovation and change. Links to the work of the Institute of HealthCare Improvement (IHI) and the role of Health Quality Ontario (HQO) in providing support and resources to facilitate this important work are provided.


As you review this video and consider the examples presented reflect on opportunities you observe in your own work setting. Pay attention to the processes described and consider examples where you may have used the PDSA cycle or something similar in a patient situation. Is thinking such as described in the video evident during meetings, team conferences, rounds in which you have participated?

Video: Quality Improvement in Healthcare (11:08)


Activity #3

Please review the summary provided on the site American Society for Quality (ASQ), which provides an overview of lean and six-sigma methodologies.


Activity #4

In this video, Don Berwick provides an overview of the 6 dimensions of quality.  Review the video and reflect on the two reflective questions posed at the end.

Video: Defining Quality: Aiming for a Better Health Care System (3:45)


Activity #5

This video provides an illustration of the PDSA Cycle.

Video: Whiteboard: PDSA in Everyday Life (4:45)


Activity #6

This video provides an excellent overview of the various levels of measurement and illustrates the importance of evaluation.

Video: Module 1 – Introduction to Measurement in Primary Care Quality Improvement (8:19)


Activity #7

Quality Improvement Plans

Health Quality Ontario (HQO), requires hospitals, long-term care homes, family health teams, community health centres, nurse practitioner-led clinics and Aboriginal health access centres to submit an annual Quality Improvement Plan (QIP).

The following is a series of videos produced by Ontario Health (Health Quality Ontario, HQO) regarding Quality Improvement, Quality Improvement Plans: Support and Training.

These videos support organizations in the development of their plans which are publicly available on the HQO website.  The approach to Quality Improvement described in these videos provides a guide for the development of quality programs in health care organizations whether or not they are required to do so by HQO.


  • Video # 1: Quality Improvement Science: The basics #1 (11.06)


  • Video # 2: Quality Improvement Science: The basics #2 (12.34)

  • Video #3: Quality Improvement Science: The basics #3 (17.40)

Activity #8

The Health Quality Ontario: QIP Navigator is where the Quality Improvement Plans of Ontario hospitals are shared.  Identify one organization and review its plans for two consecutive years.  Please note any evidence of improvement and changes in the initiatives and indicators they are focusing on.


Check Your Understanding


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Leadership for Nurses in Clinical Settings Copyright © 2022 by Dr. Kirsten Woodend, Dr. Catherine Thibeault, Dr. Manon Lemonde, Dr. Janet McCabe is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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