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Volume 15 (3)
Volume 15, Issue 3, September 1995 
J Contin Educ Health Prof 1995; 15(3):165-174
ORIGINAL ARTICLE
Curtis P. McLaughlin, DBA Arnold D. Kaluzny, PhD A b s t r a c t Continuous quality improvement (CQI) is being used to address both administrative and clinical processes. As this approach addresses more clinical processes, continuing medical education (CME) and CQI are likely to begin to interact as both become involved in improving clinical decision making. This article presents some of what is known about CQI implementation and interprets how that knowledge impacts on the changing role of CME. These lessons from the application of CQI are outlined according to the three stages of the CQI process — planning, implementation, and evaluation. For planning, CME should participate in the team designing the CQI training efforts, focusing on the role of training physicians in the community and liaison with clinical chiefs about adapting clinical guidelines to local needs. The interdisciplinary nature of the CQI teams and the need to train teams as a unit may present a challenge to established CME values. During implementation, CME staff working with CQI will need to cooperate with other staff units, such as management engineering. Staff will have to understand the strategic reasons behind their institution’s use of CQI, recognize the grief process that accompanies process change, consider different pedagogic approaches, mediate the tensions between institutional and professional process demands, and work to remove the perceived barriers to clinician participation in CQI. CME personnel will also have to monitor the ongoing evaluation efforts that will need to accompany the implementation of CQI, in order to fine tune the effort and to be able to present a balanced assessment of CQI to its constituents. Keywords: Clinical guidelines; continuing medical education; continuous quality improvement; managed care; multidisciplinary teams; total quality management |
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