CONTINUOUS QUALITY IMPROVEMENT: An Effective Strategy for Improvement of Program Outcomes IN A HIGHER EDUCATION SETTING
Brown, Jennifer Field, Marshall, Bennie L., Nursing Education Perspectives
The nursing department at a historically black university has implemented a continuous quality improvement approach to improve its program outcomes. A quality enhancement plan was designed with three major goals: to increase NCLEX-RN® pass rates, to improve student advisement processes, and to increase student satisfaction. The strategies implemented to meet these outcomes are described and evaluated.
Key Words Continuous Quality Improvement - Nursing Education - Nursing Program Outcomes
WE LIVE IN A SOCIETY THAT CALLS FOR HIGH QUALITY PRODUCTS DELIVERED WITH MAXIMUM EFFICIENCY. With increasing demands on nursing education and decreasing numbers of faculty, academicians and university administrators are striving to identify ways to work smarter, rather than harder. In the pursuit of excellence, we must ask ourselves how we can design systems and curricula to meet or exceed our expected learner and program outcomes. * This article describes quality issues present in the higher education setting, specifically, the Department of Nursing at Norfolk State University, a historically black university in Virginia. A continuous quality improvement (CQI) approach adopted by the department is presented, along with the elements of a CQl tool kit used to develop the quality enhancement plan. It is hoped that evidence of the program's effectiveness will inspire others to develop a CQI approach that facilitates change and improves program outcomes in higher education settings. (see Sidebar on following page for a discussion about historically black colleges and universities.)
Defining Quality in Higher Education The American Society for Quality identifies four dimensions of quality in education: accountability, curricular alignment, assessment, and student satisfaction (1). A quality-driven approach to improving education provides an effective method to address each of these four dimensions as follows:
* Accountability is a systematic method to assure stakeholders that an organization is producing the desired results or outcomes. In education, we are held accountable for the products we produce: our graduates. The Association of American Colleges and Universities (AACU) (2), which views student achievement of intended learning outcomes as the key indicator of collegiate quality, has as its motto, "We have not taught if our students have not learned."
* Curricular alignment is the process by which educators design courses to address program outcomes and sequence them to progress through increasingly higher cognitive levels as identified through Bloom's taxonomy (3). Curricular alignment fosters the achievement of program and university goals and requires documentation and demonstration of curricular coherence.
* Assessment is the identification of individual and collective needs and results. Assessment should be both formative and summative and should occur externally as well as within the classroom. It is imperative that schools use a variety of measures for assessing outcomes, and feedback related to assessment activities should be regular and frequent. It is not enough to simply assess. One must also use assessment findings to improve learner outcomes.
* Student satisfaction entails providing what is needed when it's needed, including faculty availability and learning/remediation resource accessibility. Students have unique learning styles that require varied teaching approaches and resources. It is not enough to use student performance as the indicator of quality; evaluation of student satisfaction is critical as well.
Continuous Quality Improvement CQI is an approach to quality assurance that was originally proposed by Walter A. Shewhart in Economic Control of Quality of Manufactured Products, first published in 1931. It has been defined as "a linear incremental improvement within an existing process" (1) and focuses on doing the right things, the right way, the first time. …