Quality Improvement: Overview for Audiologists
What is Quality Improvement?
Quality improvement (QI) is an ongoing activity that
objectively evaluates current work practices and client care
provided by educators and health care practitioners, including
audiologists. It is a process that identifies practice trends,
accepted levels of care, problems, and solutions to problems. It
provides accountability related to the efficacy and efficiency of
audiologic intervention and identifies those factors that enhance
or hinder client care.
Why do we measure quality?
Consumers, administrators, third party payers, and
policymakers are demanding objective proof that services provided
by audiologists are meeting specific standards or protocols of
care. Providing quality care is critical to both receiving
reimbursement for that care and positive outcomes of services. It
also ensures consistency in the standard of care provided by
audiologists. This consistency is measured through quality
improvement monitoring systems.
How is quality measured?
Quality improvement (QI) measures typically include indicators
for the areas of:
- structure (e.g., facilities, equipment, qualifications of
practitioners, staffing ratios, record keeping)
- process (steps taken to perform evaluation and
treatment)
- outcomes (the results of evaluation and treatment)
QI monitoring systems can gather and track data
retrospectively (after client discharge), concurrently (during
client care), and prospectively (before client care begins).
Systems to gather such data can be as simple as a checklist or as
complex as an automated relational database. The database in and
of itself does not improve quality; rather, these databases
provide information on client care trends. When a changing trend
or problem is identified, that change or problem must be
addressed and resolved. It is in the resolution of the problem or
action on change that we improve quality practice. QI measures
may serve to identify populations currently underserved and
justify additional resources to assure quality care and the
enhancement of overall services.
Where do QI activities take place?
QI programs should be implemented in public and private
schools, clinics, community speech and hearing centers,
university speech and hearing centers, private practices, and
health care settings (e.g., hospitals, rehabilitation hospitals,
skilled nursing facilities). Standards and guidelines instituted
by accrediting bodies (e.g., The Joint Commission, formerly Joint
Commission on Accreditation of Healthcare Organizations),
regulations by third party payers (e.g., Medicare, Medicaid),
laws (e.g., Omnibus Budget Reconciliation Act [OBRA]), the
profession itself (e.g., ASHA practice policy documents, the Code
of Ethics), and consumers all require objective proof that
quality services are rendered.
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