This chapter, “Complex Systems and Approaches to Quality Improvement,” serves as an introduction to complex systems management and current thinking in improvement science. It explains the context behind quality improvement (QI) initiatives, beginning with a discussion of the ultimate goals of this movement. It then briefly reviews the history of QI development and early leaders in the field. The universal elements of a successful QI or patient safety project are discussed, followed by the exploration of commonly encountered barriers to systems and individual improvement. The chapter also highlights the differences between QI work and traditional research study. Selected tools to examine and prevent risk are explored, including informal approaches, Deming’s model for improvement, Six Sigma, healthcare failure mode and effects analysis (HFMEA), and root cause analysis (RCA).
The foundations of quality improvement science
