What is Healthcare Quality Assurance?

Posted by Adam Cohen on Tue, Oct 16, 2012 @ 08:10 AM

What is Healthcare Quality Assurance

We hear the term quality assurance so often these days.  It is generally meant to describe some initiative or process by which an organization sets procedures and benchmarks for its operation, and then measures results to ensure these benchmarks are met.  This is common to all industries and businesses as they work to improve their performance.  However, there are more specific applications of this term.

Industry Trends

The trend across the healthcare industry is to establish capabilities that manage and measure provider quality.  The Joint Commission requirement for Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE) is one of many driving forces behind this trend.  While there are many variables impacting provider quality, leading healthcare organizations are realizing that integrating comprehensive recruiting, credentialing, privileging, ongoing maintenance, and quality management processes allows the firm to connect training, qualification, and experience information to provider performance.

Healthcare Quality Assurance, Defined

In light of these trends, the healthcare industry is searching for solutions that bridge these disciplines that were once viewed as separate and unrelated processes.  The name for this competence is healthcare quality assurance.  Here is a more formal definition: 

Healthcare Quality Assurance – noun – \ˈhelth\ˈker \ˈkwä-lə-tē\ ə-ˈshur-ən(t)s: The series of processes used by healthcare organizations to vet a medical provider’s clinical competency, award privileges, maintain related data, and evaluate provider performance.  The individual processes falling under healthcare quality assurance are generally known as recruiting, accession/on-boarding, credentialing, privileging/appointment, clinical risk management, and provider quality management.            


You will find “healthcare quality assurance” used in many industry materials, white papers, case studies, blogs, and websites.  Additionally, you may see healthcare quality assurance used to represent more limited combinations of the processes defined above.  For instance, some may use it to refer to only credentialing and privileging.  In these situations, the context of the materials will help you understand what the author means.

Next Steps     

In an upcoming blog, we will discuss how organizations can use an effective healthcare quality assurance capability to improve the management of their provider populations. 




Birth of the Credentials Management Organization


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About the Author

describe the imageAdam Cohen is the Director of Operations for Military Credentialing Solutions.  Adam started his career as a management consultant helping organizations design and implement new operations as well as leading organizational turn-arounds.  His strengths lie in strategy development, organizational leadership, operations analysis and design, and change management. Read more..  




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Topics: Healthcare Quality Assurance