Is quality management the same as research?

Recently I have been contemplating the difference between quality management and research studies. There seems to be a grey zone that overlaps the two, causing confusion. A number of organizations and the federal government have set expectations that health care providers and organizations need to report on quality measures. The Minnesota Community Measures is an example of a non-profit organization devoted to measuring and reporting on outcomes. Through Medicare the federal government looks at quality measures, using financial incentives with health care providers to encourage them to provide the data. Through the reporting on various measures, these organizations believe that health care will be improved and the cost lowered. The reality of whether this approach works is a topic for another time. What is important to this discussion is the need for health care organizations to understand quality and report the results publicly. However, there seems to be confusion about what this entails; are we doing research or evaluation?

Research is an ” investigation or experimentation aimed at the discovery and interpretation of facts “(Merrium-Webster, 2012). It starts with a problem and ends with a conclusion; it is not a problem solving process (Swanson, 2005, p. 4). That does not mean that research cannot be used to solve problems, this would be advancing the theoretical basis through application. In addition, research does not apply merit or value to the investigation. In an evaluation the worth of something is considered. There is a judgment being applied, a critique of the process or outcome. What makes it confusing are the methods. Both research and evaluation use scientific methods.

Scientific methods include quantitative and qualitative designs. In quantitative designs relationships are examined through variables that are described numerically and analyzed statistically (Creswell, 2003, p. 153). This can be through data collection where participants share information such as blood pressure measurements or visual acuity. For a qualitative design the researcher does not have parsimonious data, instead the observation is in a natural setting where the analysis is deductive and looking for themes and patterns (Creswell, 2007, p. 37). Scientific methods must be used in research, but it can also be helpful in quality management. Here is the grey zone. Collecting data does not make a project a research study. The purpose of the project drives the difference. If the purpose is to establish value, merit, or a judgment of worth it is quality management. On the other hand, if the project is answering a question without regard to solving a problem, it is research. For example, a project that answers the question “which patient visit method is better with regard to patient outcomes?” is a quality measurement. The alternative question, “what is the difference between patient visit methods with regard to patient activation?” is a research study. The first is placing a value statement on the results while the second is discovering a fact.

In the end what really matters is continuous improvement in patient care. The methods support the process and give credibility to the outcomes. We need both quality management and research to achieve the combined goals of higher quality and lower cost.

Creswell, J. W. (2007). Qualitative inquiry & research design: Choosing among five
approaches (2nd ed.). Thousand Oaks, CA: Sage.

Creswell, J. W. (2003). Research design: Qualitative, quantitative, and mixed methods
approaches (2nd ed.). Thousand Oaks, CA: Sage.

Swanson, R. A. (2005). The challenge of research in organizations. In R. A. Swanson, & E. F. I. Holton (Eds.), Research in organizations: Foundations and methods of inquiry (1st ed., pp. 265-280). San Francisco, CA: Berrett-Koehler.