Continual Improvement in Healthcare — From Concept to Practice

Continual improvement is not just an accreditation requirement — it’s the mindset that separates genuinely excellent healthcare facilities from those that simply achieve accreditation and stand still.

ISO 15189:2022 and NABH both require demonstrable continual improvement. But what does this actually mean in practice for a busy lab or hospital?

The PDCA Cycle in Healthcare

The most widely used framework for continual improvement is the Plan-Do-Check-Act (PDCA) cycle:

• Plan: Identify an area for improvement, analyse the root cause, develop a plan
• Do: Implement the plan on a small scale
• Check: Measure the results against the expected improvement
• Act: Standardize what worked, abandon what didn’t, begin the next cycle

Sources of Improvement Opportunities in Healthcare

• Internal audit findings
• Patient and user complaints
• Nonconformances and near-misses
• EQA/proficiency testing results
• Staff suggestions
• Benchmarking against peers
• Management review discussions
• Regulatory changes

Documenting Continual Improvement

For NABL/NABH accreditation, improvement activities must be documented. Use a Quality Improvement (QI) Register to track: the issue identified, the proposed improvement, implementation date, measurement method, and results achieved.