Quality assurance is as important in the private office as in large medical care
institutions. In hospitals or MCOs, there are many people who may observe the
medical practitioner. In small offices, if the physician is not checking on the
people he or she supervises, dangerous deficiencies may go unnoticed. The
simplest form of quality assurance for NPPs is to have the physician read and
sign every chart. This will allow correction of errors and ongoing education of
the nurse or physician’s assistant.
There should be a formal quality assurance program, usually a chart audit.
Sample charts should be reviewed for every provider and for a range of patient
problems. Each case should be evaluated to see if the protocols were followed
and if the care was documented properly. General considerations, such as
whether the entries were made at the time the care was rendered and
whether they can be read by the other providers, should be included in the
audit. At intervals, the actual care rendered should be checked. The chart entry
may be perfect, yet bear no relationship to the patient’s actual condition.
Every quality assurance program should have a system for correcting all
identified deficiencies. It must have provisions for changing questionable
practices and for immediately suspending anyone who may be dangerous to
patients for any reason.