Geraldine Glenn

Publication Date


Advisor(s) - Committee Chair

Wayne Higgins, David Dunn, Thomas Nicholson


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Degree Program

Department of Public Health

Degree Type

Master of Science


Continuous Quality Improvement (CQI) is a philosophy which promotes an environmental culture of working together. It involves a process of continual improvement and innovation, to meet and surpass the needs and expectations of an organization's internal and external customers. The quality improvement process trains employees to examine complex, everyday processes, step by step from the customer's point of view. CQI must pass from the top down throughout the organization. In order to effectively do this, managers must be well-prepared to carry out their roles as team leaders. Team building is an integral component of CQI. This study explored the continuous quality improvement concepts of Deming, and others.

Industry estimates indicate 30 percent of total dollar volume In health care is spent fixing problems that arise from poor quality. The ultimate goal of quality improvement is to provide better patient care. The customer focused environment of cooperation and continuous improvement promotes improved patient outcomes – a satisfied customer will be the truest measure of success.

This study utilized a "team assessment questionnaire" published in Healthcare Forum Journal, and used with permission. The survey tool provided a mechanism for evaluation of the management team's current strengths or weaknesses regarding team building skills. The instrument was designed to calculate scores in the categories of roles, activities, relationships, and environment, based upon the opinions of the management team. It enabled evaluation of areas that might require further training and education, prior to full implementation of the CQI program.

The study rejected the hypothesis: when a hospital implements quality improvement concepts, the management team does not have developmental needs in the areas of roles, activities, relationships, or environment, as determined through their responses to the following statements.

  1. People are clear about goals for the gourp.
  2. Unnecessary procedures, policies, and formality are minimized.
  3. Team members feel free to develop and experiment with new ideas and approaches.
  4. The allocation of rewards is perceived to be based on excellent performance.
  5. Recognition and praise outweigh threats and criticism.
  6. Calculated risk-taking is encouraged.
  7. People are clear about their responsibilities and expectations for performance.
  8. People are clear about how their roles / responsibilities interrelate with those of others.
  9. People perceive others in the work group to be high performers.
  10. People are clear about what personal characteristics / competencies are necessary for superior performance in their jobs.
  11. The team produces high-quality decisions, products, services.
  12. The team is able to conduct effective meetings.
  13. The team achieves its goals.
  14. The team and its individual members are able to interact effectively with others outside the team.
  15. The team makes decisions and produces output in a timely fashion.
  16. The team members truly support each other in carrying out their respective responsibilities.
  17. Team members are open in their communications with each other.
  18. Team members follow through on commitments.
  19. Team members trust each other.
  20. All team members are equal contributors to the team process.
  21. The group often evaluates how effectively it is functioning.
  22. Individual members feel committed to the team.

Findings revealed needs crossed the four developmental areas of roles, activities, relationships, and environment; specific areas of strength or weakness were not identified. The findings of this study were similar to results of the HayPoll, a telephone poll conducted by Healthcare Forum Journal.

The conclusion is that training in all four areas is necessary as a component of the CQI program for the facility studied. This training would enable the management team to reinforce previous learning, and provide information where it is needed.


Health and Medical Administration | Health Services Administration | Medicine and Health Sciences | Public Health | Quality Improvement