QUAD A has recently posted new Standards Manuals that will be effective April 7, 2025. These manuals contain two new categories of information – Interpretive Guidance and References. What is their purpose? How are they to be used by surveyors and facilities?
Both the Interpretive Guidance and Reference information is intended to provide support to surveyors and facilities. They are not meant to be prescriptive. Their use is not required.
The Interpretive Guidance identifies the intent of the standard, best practices, and recommended ways of achieving compliance. It provides clarification and interpretation of the standards and outlines steps that a facility can take to become and remain compliant with QUAD A standards. The guidance is based on nationally recognized standards of practice and recommendations. It also contains information to guide the surveyor’s activities during the onsite survey, including when and how to make observations, conduct interviews, and review the types of documents and records that must be reviewed to assess compliance.
Compliance will be evaluated based on the language of the standard. A facility will not be scored based on the guidance. There is more than one way to achieve compliance. Compliance is evaluated in multiple ways, including review of facility policies and procedures, observation of care, interview of staff and patients, along with a review of personnel and clinical records, logs, written documentation, and meeting minutes, as appropriate. In accordance with QUAD A policy, if 100% compliance is not achieved, the standard will be marked “deficient.”
A facility is expected to base their delivery of care, treatment or services, and policies and procedures on nationally recognized standards of practice and recommendations. It is acceptable for a facility to use other evidenced-based information than what is contained in the guidance. In this case, the facility must identify the source of their information. Facilities are also required to follow the manufacturer’s instructions for use and state/provincial, federal and local law, when applicable.
A facility is not required to use the references. Again, they are meant to be a support and source of information for facilities and surveyors. A facility may choose to use all, some or none of the references included. A facility is free to use other sources to provide safe quality care and meet the needs of the population they serve.
Note: The requirements in the current version of the QUAD A standards supersede previous versions, including any interpretive guidance provided in past newsletters and responses to standards-related questions.
Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.
