Continuous quality improvement revisited.

The author re-examines the appropriateness of continuous quality improvement (CQI) management techniques in health care with reference to the stability of North America's work force, staff's difficulty in balancing new responsibilities with everyday tasks, the need to adjust after major change, the real value of group decision making, the proper use of analytical tools, the validity of "meeting customer expectations", cultural inconsistencies in evaluating CQI programs, and the tendency to focus on management techniques instead of larger issues in times of crisis. The author concludes that the health care field can utilize CQI most effectively by integrating its techniques into societal and organizational cultures.