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 organizations 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 organization’s medical director and are run out of a dedicated department. These programs are designed to analyze health care requirements, determine ways of ensuring that protocols are followed throughout the organization, 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 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 organization complies with mandatory requirements. Noncompliant organizations face risks such as legal reprimands as a consequence of not following the medical, state or federal health care rules. As such, health care organizations value their quality assurance programs, as these programs ensure an organization is doing its due diligence to maintain compliance.
Measurability, which is taken from the quantitative approach that quality assurance programs use, is important in health care quality assurance systems. The measurable data 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 organizations. They are not intended to create more work for the health care organization. Nevertheless, 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 experience resistance when directing departments to create performance improvement projects, for example.