02 — Capability · BC-1850
Quality & Patient Safety
Measure and improve the quality and safety of the care the organization delivers or pays for, learn from every harm and near miss, stop infections spreading inside its facilities, confirm each clinician is qualified for what they do, and stay ready for accreditation surveys. Product quality and the safety of staff at work are owned elsewhere.
- Clinical Quality
- Quality and Safety Program
- Clinical Governance
- Patient Safety Program
In scope
- Quality measure collection, submission and improvement programs
- Patient safety event reporting, investigation, disclosure and learning
- Infection prevention, surveillance and outbreak response
- Medical staff credentialing, privileging and accreditation readiness
Out of scope
- Product and manufacturing quality systems (see BC-550)
- Workplace injuries and staff safety incidents (see BC-810.20)
- Hiring and pre-employment checks for employees (see BC-320.30)
- Outcome registries and research data (see BC-1880.50)
Realized by · 4
- Epic · Cosmospartial via BC-1850.10.40
- Oracle Health · Service Line and Department Solutionsstrong via BC-1850.30.10
- MEDITECH Expanse · Population Health and Care Compassstrong via BC-1850.10.40
- MEDITECH Expanse · Surveillancepartial via BC-1850.30.10
Used in · 3
- Admit-to-Discharge · 05 Keep Safe via BC-1850.20
- Admit-to-Discharge · 07 Measure & Improve via BC-1850.10
- Enroll-to-Care · 06 Measure Outcomes via BC-1850.10
Build it · 0
- Nothing in the library points here yet.
Decomposes into · 5
- BC-1850.10Clinical Quality MeasurementKnow how well the organization's care performs against required measures and its own goals, submit measures to regulators, payers and quality programs accurately and on time, and improve where results fall short. Inspecting and testing products is general quality management.
- BC-1850.20Patient Safety EventsCapture every event that harmed or could have harmed a patient, investigate serious ones to their causes, tell patients and authorities what the law requires, and share what was learned so it does not recur. Staff injuries are health and safety.
- BC-1850.30Infection PreventionKeep infections from being acquired or spread in the organization's facilities by watching for them, acting fast on clusters and outbreaks, checking that prevention practices are followed and reporting infection data the law requires. Reprocessing instruments is sterile processing.
- BC-1850.40Credentialing & PrivilegingConfirm that every physician and advanced practitioner is licensed, trained and fit to practice before they treat patients, grant privileges that match proven competence, and recheck both on a set cycle. Hiring employees and enrolling clinicians with payers are owned elsewhere.
- BC-1850.50Accreditation ReadinessStay ready at all times for accreditation and regulatory surveys, many of them unannounced for hospitals, and for health plan accreditation reviews and program audits, by tracking every applicable standard, running mock surveys, hosting surveyors and closing findings on time. The wider obligations register is compliance.