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HCA 321: Continuous Quality Improvement in HCA

Course Description

In the context of the transition to value-based care, this course is intended to provide a basic interdisciplinary perspective on quality management which includes measuring and improving quality and heavily engages the patient. This approach to quality management examines the unique tools and processes fundamental to Continuous Quality Improvement (CQI), the human resources that fuels the processes and the critical role of health information technology.


  • HCA 101: Health Care Systems Administration
  • ENG 101: English Composition 1
  • ENG 102: English Composition 2

Student Learning Outcomes (SLOs)

Students who successfully complete this course will be able to:

  1. Examine the underlying philosophy of Total Quality Management (TQM) and CQI with its structural elements, its health care-associated elements, and the context within which these elements must function.
  2. Describe the basic underlying tools and approaches to TQM/CQI and the fundamentals of measurement and statistical analysis applied in CQI efforts.
  3. Discuss the specific application of CQI to a variety of health service settings including primary care, public health departments, hospitals, academic medical centers and long-term care organizations.
  4. Demonstrate an understanding of CQI through case studies and related research.
  5. Explain how quality is an integral part of value-based purchasing.
  6. Analyze the challenges to quality measurement under a population health program.

General Education Outcomes (GEOs)

Please check the applicable GEOs for this course, if any, by outcomes at GEO Category Search, or by subject area at GEO Discipline Search.

Course Activities and Grading



Discussion Questions (Weeks 1-7)


Research Paper Due (Week 7)


Research Paper Presentation (Week 8)




Required Textbooks

Available through Charter Oak's online bookstore

  • Sollecito, W.A. and J.K. Johnson. McLaughlin and Kaluzny’s Continuous Quality Improvement in Health Care. 4th ed. Burlington, MA: Jones & Bartlett, 2013. ISBN-13: 978-0-7637-8154-5

Course Schedule



Readings and Exercises




Topics: Introduction to CQI, Measurement, and Team Effectiveness

  • Chapter 1,The Global Evolution of Continuous Quality, pp. 1-44.
  • Chapter 2, Factors Influencing the Application and Diffusion of CQI in Health Care, pp. 49-71.
  • Chapter 3, Measurement, Variation, and CQI Tools, pp. 77-114.
  • Chapter 4, Understanding and Improving Team Effectiveness, pp. 117-153.
  • Read assigned chapters
  • Thread 1: What are the distinguishing characteristics and functions of CQI?
  • Thread 2: What is the value of the PDSA Cycle?



Topic: Patient Satisfaction

  • Chapter 5, The Outcome Model of Quality, pp. 155-179.
  • Chapter 6, Measuring Consumer Satisfaction, pp. 181-196.
  • Chapter 7, CQI, The Role of the Patient in Continuous Quality Improvement, pp. 199-217.
  • Chapter 8, A Social Marketing Approach to Continuous Quality Improvement Initiatives, pp. 225-245.
  • Read assigned chapters
  • Thread 1: Discuss the measurement of quality through patient satisfaction.
  • Thread 2: Why is risk adjustment an important consideration in measuring outcomes?



Topics: Risk and Implementation

  • Chapter 9, Assessing Risk and Harm in the Clinical Microsystem, pp. 249-271.
  • Chapter 10, CQI, Transformation, and the “Learning” Organization, pp. 275-306.
  • Chapter 11, Classification and Reduction of Medical Errors, pp. 311-330.
  • Chapter 12, The Role of Health Information Technology in Quality Improvement From Data to Decisions, pp. 335-361.
  • Read assigned chapters
  • Thread 1: What are some challenges in adopting HIT to CQI?
  • Thread 2: Why is CQI ineffective?
  • Submit title of research paper by Friday to the instructor



Topic: Applications

  • Chapter 14, Quality Improvement in Primary Care: The Role of Organization, Systems, and Collaboratives, pp. 399-415.
  • Chapter 15, Quality Improvement Organizations and CQI in Medicare, pp. 421-442.
  • Read assigned chapters
  • Thread 1: What is the consistent plan in place of evaluating Medicare patient care?
  • Thread 2: What are some of the challenges in adopting QI in Multi-Specialty
    Group Practices?



Topic: CQI in Nursing

  • Chapter 17, Quality Improvement in Nursing, pp. 485-506.
  • Read assigned chapters
  • Thread 1: Discuss how CQI can be improved in nursing.
  • Thread 2: Outline what a nursing safety culture might look like in a nursing home setting.



Topic: Accreditation

  • Chapter 18, Accreditation: A Global Regulatory Mechanism to Promote Quality and Safety, pp. 513-531.
  • Read assigned chapters
  • Thread 1: What are three key issues currently under-researched in health care
  • Thread 2: What is the role of the Healthcare Facilities Accreditation Program and Det Norske Veritas Healthcare Inc.?



Topic: Future of CQI

  • Chapter 20, A Call to Action for Transforming Health Care in the Future, pp. 571-592.
  • Review previous readings
  • Thread 1: Based upon your learning in this course, please explain the advantages and disadvantages of quality improvement teams.
  • Thread 2: What are the challenges in moving towards Value-Added Health Care?
  • Submit Research Paper to instructor and discussion forum by Friday



Topic: Conclusions and Presentations


  • None
  • Define Population Health Management.
  • Tell the class about what you learned from your research paper. This is time for you to shine and teach the class.

COSC Accessibility Statement

Charter Oak State College encourages students with disabilities, including non-visible disabilities such as chronic diseases, learning disabilities, head injury, attention deficit/hyperactive disorder, or psychiatric disabilities, to discuss appropriate accommodations with the Office of Accessibility Services at

COSC Policies, Course Policies, Academic Support Services and Resources

Students are responsible for knowing all Charter Oak State College (COSC) institutional policies, course-specific policies, procedures, and available academic support services and resources. Please see COSC Policies for COSC institutional policies, and see also specific policies related to this course. See COSC Resources for information regarding available academic support services and resources.