The quality improvement cycle (QIC) in clinical practice: colorectal cancer detection.

In adapting quality improvement techniques originally developed by industry to an HMO medical delivery system, Harvard Community Health Plan (HCHP) applied the Shewhart quality improvement cycle (QIC) to colorectal cancer detection. An initial increase in the number of members routinely tested led to a second QIC to improve consistency of clinical evaluation of members with positive fecal occult blood test results. The successful use of these QICs suggests that similar techniques have a role in improving basic clinical skills and in the evaluation and therapy of common clinical conditions.