Health care systems should include midwives in an established quality assurance program. Midwives who are not included in an existing program are encouraged to develop their own program. Peer review is the assessment and evaluation of midwifery practice by other midwives to measure compliance with ACNM standards. In the peer review process, a midwife's practice undergoes scrutiny for the purpose of professional self-regulation. All participants in the peer review process have the opportunity to enhance professional knowledge and skills.
Quality improvement modifies the process for providing care in order to improve outcomes.
Modifications are based upon the measurement of parameters such as patient satisfaction, clinical outcomes, population-specific care, appropriate use of technology and resources, and access to care.