CQI simply means Continuous Quality Improvement.
Explanation: By way of introduction, in the 21st Century, health care systems across the world are focusing policy efforts on improving the quality of healthcare delivered to their population.
Strengths and weaknesses of Continuous quality improvement according to Historians are as follows:
1. Quality improvement documentation: In 1854, British troops fought in Crimea and the surrounding area to force Russians to leave the Turkish territories of Moldavia and Wallachia. Cholera and diarrhea were responsible for a great deal of mortality among the British troops, and the British government sent a group of nurses to accompany Florence Nightingale to Turkey to help care for the soldiers. Within six months of the arrival of Florence Nightingale, the mortality rate from disease dropped from 42.7% to 2.2%.
Some of Nightingale’s specific improvements were, the reduction of overcrowding (beds had to spaced three feet apart), provision of ventilation, the removal of Calvary horses that were being stabled in the hospital basement, assuring the sewers leading from the hospital were flushed several times a day and disinfecting the latrines/drains with peat charcoal (Nightingale, 1863).
2. Sanitary commissions: As the American civil war formally began in 1861, the Sanitary Commission was founded as a partnership or alliance of relief organizations. It was based on lessons learned from the Crimean War with the purpose of promoting clean and healthy conditions in the Union Army camps and hospitals.
Clara Barton was a civilian volunteer who supervised nursing care to soldiers primarily in the state of Virginia to help meet the goals of the Sanitary Commission. She was assisted by Dr. Elizabeth Blackwell, who worked with Florence Nightingale in England and was the first female to graduate from medical school in the U.S. (Oats, 1994).
3. Improvisation and innovation: Historians identify Louis Pasteur as one of the “greatest benefactors to humanity of all time”. He was a French chemist who discovered that disease was caused by microorganisms or microbes, which later became known as germ theory (Chamberland, 1904).
During the Influenza Pandemic, Dr. Blue’s quality tools were, quarantine (including ships entering the country), mandatory medical exams for all immigrants entering the country, communication in the form of weekly newsletters that contained information about the latest outbreaks, and the results of influenza research conducted at the Hygienic Laboratory which continues to exist today. In addition to the pandemic, Dr. Blue was faced with outbreaks of polio, smallpox, and typhoid. He knew how disease was spread but science had not advanced enough to stop it. He also did not have antibiotics at his disposal which would have benefitted approximately half of the influenza victims that died from secondary bacterial infections and sepsis (Gernhart, 1999).
In the United States, efforts to contain influenza in 1918 focused the use of quarantine and masks while in public, similar to the response by countries affected by the outbreak of SARS in 2003 (Center for Disease Control, 2012). Dr. Blue is viewed by many historians to represent the kind of visionary quality leader needed in the event of global disease pandemics of the future. The medical records kept during the 1918 influenza pandemic continue to be some of the most researched archival documents used by international scientists today. They serve to inform how we should respond to a similar widespread outbreak of biological disease, and provide data on the long term effects of the flu on pregnant woman.
4. Sterilization: An early prototype of the modern-day autoclave was invented in 1879 by Dr. Charles Chamberland, a French physician and biologist (Chamberland, 1904). His research was influenced by journal entries from the year 1679 by a British physicist, Dr. Denis Papin who invented the pressure cooker and research conducted by Louis Pasteur, with whom he frequently collaborated (Encyclopedia Britannica Science and Technology, 2013).
Jonas Salk reported that, of all the advances in healthcare quality, few can rival the discovery of vaccines. Some of the more well-known vaccines discovered between 1881 and 1955 are:
i. Anthrax – discovered in 1881 by Louis Pasteur who also discovered the Rabies vaccine in 1885.
ii. Diphtheria – discovered by Emil von Behring and Shibasaburo Kitasato in 1891.
iii. Tetanus – discovered in 1924 by Pierre Descombey.
iv. Polio – discovered by Jonas Salk in 1955.
v. Pertussis – discovered by Pearl Kendrick, Grace Eldering and Margaret Pittman in 1949.
In 1928, the “Wonder Drug” penicillin was discovered by Sir Alexander Fleming in England.
International Journal of Africa Nursing Sciences (Volume 1, 2014, Pages 18-22).
