Activities and programs intended to ensure the standard of care in a defined medical setting or program. Such programs must include educational components intended to remedy identified deficiencies in quality, as well as the components necessary to identify such deficiencies (such as peer or utilization review components) and assess the program’s own effectiveness. A program which identifies quality deficiencies and responds only with negative sanctions, such as denial of reimbursement, is not usually considered as a quality assurance program, although the latter may include use of such sanctions. Such programs are required of IIMOs and other health programs assisted under authority of the PHS Act (e.g., section 1301 (c) (8)).
Processes and products are acceptable and in conformance to requirements.
The efforts to determine the quality of care (find out the quality being provided), to develop and maintain programs to keep it an at acceptable level (quality control), and to institute improvements when the opportunity arises or the care does not meet the desired standard of care (medical) (quality improvement).