Q uality assurance is defined as an evaluation of the conditions under which care is provided. Quality assurance involves the identification of a problem, the determination of the source and nature of the problem, an assessment on how to effect improvement in the situation, the design of policies for remedying the problem through appropriate methods, and implementation of those policies and monitoring of the methods applied to see if they have been effective. D octors and other licensed providers apply to the medical staff of a hospital, HMO or PPO for an initial appointment and every two years must submit a reappointment application. S imilar provisions are in the bylaws of HMOs and PPOs, although exclusion of a doctor can be done without a fair hearing and without cause in these organizations. I ncidents in hospitals tend to occur over and over again so that in time hospitals write policy to avoid the recurrence of such incidents.
Policy derives from quality assurance activities.
F alls are common especially in the elderly and confused patient during the first day of stay. Measures are then taken to prevent the fall from occurring. Nursing staff should be familiar with these policies and in the nursing assessment identify the fall-prone patient and implement the policy. T he housing of a patient in an area of the hospital not conductive to safe confinement is a breach of most hospital policies about patient safety. T here are many architectural requirements that should be followed in the design of a psychiatric unit or chemical dependency unit.