A majority of health care organizations in the United States have adopted or are adopting a QI paradigm, largely because the major accrediting agencies emphasize this approach. Some organizations use the term continuous quality improvement (CQI), while the Joint Commission has adopted the term performance improvement (PI) for these activities. While QI should be the main quality approach for oral health programs, a comprehensive quality approach will include both QA and QI aspects. To put it another way, QA focuses on finding and analyzing existing problems, while QI is all about fixing the processes and systems that typically cause those problems. For the sake of consistency, the term QA/QI will be used in the remainder of this unit.
There is no one right approach for implementing QA, QI, CQI, or PI. The best tactic for any organization is to understand the different theories and apply them in a way that best fits the organization's unique culture, environment, and focus and then apply the term that best describes that approach. Each clinic should determine its own quality-management system and document this in the clinic policy manual.