Quality Assurance Programs in Medical Clinics

Quality assurance programs are vital to the healthcare industry, and have become one of the main cornerstones of healthcare. In the February 2005 issue of "Home Health Care Management Practice," Susan Carmichael reasons that quality, in the healthcare industry, is achieved when services are accessible, provided in an efficient manner and are cost-effective. Quality assurance programs are compliance-driven, and serve to ensure that a healthcare organization is operating with high quality standards to provide high quality healthcare services.

Quality Assurance Program Structure

Quality assurance (QA) programs are designed to objectively and systematically monitor the quality and appropriateness of medical or clinical care. In the healthcare field, quality assurance programs are typically overseen by the organization's medical director. The medical director is charged with developing quality management deliverables that contain measurable objectives. These objectives are determined based on healthcare regulatory requirements, legal requirements and standards of medical best practice. It becomes the head of the QA program's responsibility to monitor and evaluate the compliance for each deliverable. The deliverables are linked to a performance standard, which establishes the measures with minimum thresholds and goals for performance. These become the benchmarks that determine how compliant or non-compliant a deliverable is upon review.

Evaluation Methods

Evaluation methods are designed to capture specific information that a healthcare company is interested in monitoring. Evaluation methods usually involve the creation of evaluation tools, which are used to document hard data and statistics. One of the most common evaluation tools used in healthcare quality assurance programs is an audit tool. Auditing is the process by which documentation is reviewed, processes are analyzed and outcomes are evaluated for compliance to see if they meet the minimum performance standards. Auditing tools serve as the vehicle by which the data will be captured. They are assessments that use a rating or scoring scale to measure compliance. Sometimes, audit tools can have simple or complex formats. One type of audit tool with a simple format is a checklist. More complex audit tools include scoring systems with numbers or percentages.

Performance Improvement Projects

Not all evaluations lead to the requirement of performance improvement projects. It is the lead of the QA program's responsibility to determine whether performance improvement projects are necessary, based on data collection and analysis after the completion of an audit. Evaluations that result in low scores will indicate a need for an improvement project. Areas that score high, however, can remain doing business as usual. If the QA program determines that a performance improvement project is necessary, it means there is a deficiency or problem that needs improvement or correction. These are constructive projects that are used to help healthcare organizations identify ways to be more efficient and reach higher levels of quality.