What is quality assurance in health care?

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Anyone who works in the health care industry can attest to the regulations and mandates that permeate the system. Due to the exorbitant amount of protocols, health care organisations rely on quality assurance programs to develop ways to monitor and ensure that mandatory standards are being met.


Quality assurance programs in health care industries are usually overseen by the organisation's medical director, and are run out of a dedicated department. These programs are designed to analyse health care requirements, determine ways of ensuring that protocols are followed throughout the organisation, have a system in place to audit the protocols for compliance and institute performance improvement plans when standards are not met. Quality assurance programs use a quantitative approach to gathering and generating statistics used to determine areas of progress and deficiency.


Many departments rely on quality assurance programs to keep things in check, identify areas for improvement and work with other staff to make sure that regulations are clearly interpreted and followed. Quality assurance programs begin by creating policy and procedure manuals that exhibit all the clinical and business processes in the company. From there, the program develops monitoring or audit tools that capture quantitative data to measure compliance. Each compliance point is associated with a performance standard, which is what quality assurance programs use as a benchmark in audits. When deficiencies are discovered, the quality assurance program will assign performance improvement projects to bring the area into compliance.


Quality assurance programs make sure a health care organisation is not out of compliance with mandatory requirements. In health care, noncompliant organisations face many risks, including legal reprimands, as consequences to not following the medical, state or federal health care rules. As such, health care organisations value their quality assurance programs, as these programs ensure an organisation is doing its due diligence to maintain compliance.


In the April 2008 issue of "Quality in Higher Education," Bjrn Stensaker discusses the importance of having measurability in health care quality assurance systems. Measurability is taken from the quantitative approach that quality assurance programs use. The reason measurable data is important in health care quality assurance is because it implies a level of evidence-based practices. By having valid data, more information can be gathered for process improvement projects or compliance regulations.


In health care compliance, quality assurance programs serve as the middlemen between regulating authorities and the health care organisations. Consequently, quality assurance staff are commonly viewed as being the bearers of bad news, especially when it comes to enforcing new mandatory policies. Quality assurance staff may also experience barriers or challenges, such as being met with resistance when it comes to enforcing departments to create performance improvement projects. The bottom line is that quality assurance programs do not intend to create more work for the health care organisation. They are just trying to monitor the compliance.