Even the best quality assurance program requires periodic review in order to attain or regain maximum efficiency and effectiveness. The JCAHO standard for annual QA program evaluation adds impetus to this obligation. Riverside Methodist Hospitals' QA program evaluation is constructed in a three year cycle. Internal evaluation in year one and external expert evaluation in year three are balanced in year two with a combined internal/external program review. The year one internal evaluation discussed in the article outlines a framework for evaluation which includes positioning the evaluation for maximum influence, identifying key QA program components and designing meaningful, comprehensive evaluation inputs. The informed judgments of professionals, as well as traditional documentation review, provide powerful evaluative insights. Evaluation outputs include a program rating, an identification of program strengths and weaknesses, and targeted recommendations for QA program improvements.
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