title: Implementing CQI on a budget: a small hospital's story.
abstract: BACKGROUND
  The need to move toward continuous quality improvement (CQI) is often perceived as a financial hardship on large and small hospitals alike. Avista Hospital, a small, 50-bed hospital, accepted the challenge to implement CQI in a thorough but cost-effective manner.
  
  
  METHODS
  Without the use of consultants, the CQI process was developed internally using formal and informal methods of education for the change agents, and just-in-time education for improvement teams. All employees were involved in a brainstorming session to introduce them to the concept of CQI and to define quality and identify customers. The implementation plan was established on a five-year timeline to provide a methodical and systematic approach, and the entire process was under the direction of a quality council. ROUNDTABLES: To date 18 RoundTables have been chartered by the quality council. One RoundTable, "The Care of the MI [myocardial infarction] Patient," addressed the lack of continuity in the teaching of the MI patient. The team developed a teaching plan, with all printed materials provided in a binder to patients.
  
  
  CONCLUSIONS
  The overall cost to implement the five-year plan, including education, staff time, and a budgeted amount to begin recognition celebrations in 1995, was estimated at $10,000. Commitment and determination are the necessary components for implementation of a CQI program. With proper planning and support from the administration, a small hospital can be successful at CQI.
authors.affiliation: Avista Hospital, Louisville, CO 80027, USA.
authors.forename: B
authors.initials: B
authors.lastname: Dugar
mesh_terms: D002017:Budgets; D003120:Colorado; D003362:Cost-Benefit Analysis; D005377:Financial Management, Hospital / Q000458:organization & administration*; D006743:Hospital Bed Capacity, under 100; D006801:Humans; D009936:Organizational Innovation; D010347:Patient Care Planning; D011367:Professional Staff Committees; D016730:Program Development; D017749:Total Quality Management / Q000458:organization & administration*