To better serve our accredited facilities, QUAD A is introducing Observation of Care for all non-Medicare programs as part of the accreditation survey process.
This initiative enables a real-time evaluation of your facility's compliance with QUAD A standards through direct observation of care, treatment, and services.
At QUAD A, our Board of Directors—composed of experienced physicians and accreditation experts—strongly supports this implementation. By providing invaluable insights into daily clinical operations, this approach helps drive meaningful improvements and ensures that our standards remain rigorous, relevant, and aligned with our mission of Patients First, Always.
During the survey, observations may include full procedural or surgical observation. Our expectation of the surveyor is that they will be unobtrusive, allowing your facility to operate smoothly. These observations allow us to assess how well your facility’s practices are aligned with your policies and QUAD A Standards — ultimately reinforcing your commitment to safe and efficient patient care.
Learn more about why Observation of Care plays a crucial role – read on for an in-depth explanation!
Purpose & Scope of Observation
Observation of Care is not a peer review; the surveyor is not there to evaluate surgical techniques, procedural decisions, or clinical judgment. Instead, they assess adherence to QUAD A standards in key areas that directly impact patient safety and quality of care.
- Patient Identification – Verifying correct patient identification before procedures.
- Time-Out Process – Confirming procedural pauses for safety checks.
- Handoff Communication in PACU – Assessing how patient information is transferred during care transitions.
- Infection Control and Sterilization – Evaluating hand hygiene, high-level disinfection, and cleaning protocols.
- Room Turnover Procedures – Monitoring efficiency and cleanliness between procedures.
- Medication Management – Validating proper labeling, administration, and storage.
- Discharge Process – Confirming safe and effective patient release practices.
Preparing for a Smooth Survey
Taking the following steps will position your facility for a seamless and efficient survey:
- Provide Up-to-Date Surgical Calendars – Share procedure schedules in advance, including the number of cases scheduled and their procedures, to allow surveyors to plan observations effectively.
- Obtain Patient Consent for Observation—Inform your patients and obtain their consent for the surveyor to observe their care. This maintains transparency and prevents delays.
What to Expect the Day of Your Survey
Knowing what to expect from the Observation of Care portion of your survey will minimize disruptions and keep staff focused on patient care.
- Unobtrusive Surveyor Presence – Your surveyor will be discreet and will not interfere with patient care.
- Clear Communication and Collaboration – Your surveyor will collaborate with facility staff to plan the survey agenda.
- Request for Surgical/Procedural Schedules – A list of scheduled cases for the day will be requested, allowing your surveyor to determine which procedures or care activities to observe.
- Multiple Case Observations – If more than one case is scheduled, your surveyor may observe care provided to more than one patient, depending on the survey flow, time, and resources.
- Surgical Attire Requirements – For hygiene and safety, your surveyor may request appropriate surgical attire to wear while in the clinical areas.
- Patient Interaction – Your surveyor will introduce themselves to the patient and explain their role.
- Partial or Full Observation of the Case – All or part of a procedure(s) may be observed, depending on what is most relevant to the survey process.
- Observations Beyond the Operating Room – Your surveyor may also observe patient care outside of the operating room, such as in recovery or during transitions of care.
- Engagement with Facility Staff – The surveyor may ask your team questions about processes, policies, and procedures related to the care being observed.
Why Observation of Care Matters
Our Board of Directors recognizes the critical role that real-time observation plays in strengthening patient safety and quality of care.
- Real-World Insight into Policies and Procedures – Direct observation offers the most accurate view of how your facility’s policies and procedures are implemented in everyday patient care settings.
- Assessment of Compliance – Observation enables your surveyor to determine whether patient care is being delivered in accordance with QUAD A Standards.
- Identifying Gaps in Practice – Observation allows for identification of potential gaps between written policies and actual practices.
- Enhancing Accountability and Safety—Observation fosters greater consistency and standardization from patient to patient and from accredited facility to accredited facility. This directly supports patient safety and reinforces our core principle: Patients First, Always
By understanding the purpose of and preparing for the Observation of Care process, your facility can demonstrate not just compliance but a commitment to continuous improvement and optimal patient outcomes. This is an opportunity to showcase the efficiency, quality, and dedication that sets your facility apart.
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.
