Quality Improvement

Quality improvement (QI) is a continuous process that evaluates work practices and client care across clinical and educational settings. Audiologists and Speech-language pathologists (SLPs) often contribute to QI efforts, and their practice may be shaped by QI initiatives.

Understanding Quality Improvement

Why does QI matter?

Audiologists and SLPs are expected to provide high-quality care that meets the standards of consumers, employers, insurance companies, and policymakers. ASHA’s Code of Ethics supports this by stating that individuals are expected to use all available resources—including referrals and/or interprofessional collaboration when appropriate—to ensure that quality service is provided.

Measuring and improving quality helps Audiologists and SLPs

improve patient outcomes and safety,
improve the care experience for patients and their care partners,
lower health care costs,
keep services consistent, and
meet requirements from insurance companies, regulators, and accrediting bodies (Mate et al., 2020; Mormer & Stevans, 2019).

How is quality measured?

The Donabedian model, Structure-Process-Outcomes, is a widely used framework for measuring and improving quality in health care.

The model organizes quality into three domains:

Structure: The resources we have.

The people, tools, and systems that make care possible.

Physical environment and facilities
Equipment and tools
Staff knowledge, skills, and training
Staffing levels and caseload size
Facility policies and protocols
Record management

Process: What we do with and for patients.

The clinical actions and interactions between patient and clinician.

Screening, assessment, and treatment
Patient and care partner education
Discharge planning and follow-up

Outcomes: The results of care.

What happened to the patient as a result of the care they received.

Outcome measures
Patient satisfaction scores
Length of stay
Hospital-acquired infection rates
Morbidity and morality rates

When is quality measured?

QI systems track information at different stages in care:

before care starts
during care
after care ends

These QI systems range from simple tools (like checklists) to more complex ones (like data dashboards) that help teams catch problems early and improve care.

Where does QI happen?

Audiologists and SLPs take part in QI activities across many settings:

schools
clinics
university speech and hearing centers
private practice
health care facilities (e.g., hospitals, rehab centers, and skilled nursing facilities)

Organizations like insurance companies, accrediting bodies, and professional associations—along with clients—expect clear documentation that the facility is delivering high-quality care.