Quality improvement into practiceBMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m865 (Published 31 March 2020) Cite this as: BMJ 2020;368:m865
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Quality Improvement  is a buzz word in modern healthcare organizations and it is the core and most important aspect of services rendered by any healthcare facility.
Quality guru Joseph Juran  described quality as “FIT for USE”, which indicates that the success and failure of any service /product can be measured through its fitment in the systems of the organisation and the premise of customer base. Healthcare settings are a complex matrix system  in which simple intervention could affect the outcome. According to the Donabedian model , in every quality initiative, the basis for measuring quality improvement are the structures, processes and the outcomes (or inputs, processes and the output). The output or the efficiency always depends upon inputs and the processes. The structures or inputs are expensive affairs as they they are resource demanding (resources are always limited in any organisation). Therefore, the primary focus for improving quality should be on processes improvement. In process improvement, one needs the organizational involvement in creating their own standard operating procedures (SOPs)
Creating customized standard operating procedures (SOPs) is the first step of any quality assurance initiative.The development of Institutional SOPs needs the involvement of staff, continuous support and mentoring. As Aristotle said, ”Quality is not an act but a habit”. Ensuring standard practices and adherence to standards, changing behavior and attitude of the staff is not an easy task. It needs rigorous monitoring tools, continuous support and engagement of the staff and, most importantly, the ownership of the staff working at the facility for implementation and sustainability of the Q.I efforts.
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Competing interests: No competing interests