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Compliance as a quality challenge: Working together to improve the organization

Denise A. Atwood ( is Chief Risk Officer, District Medical Group Inc. in Phoenix, AZ. Nathan J. Ward ( is Manager, Compliance & Content Development, youCompli in Pittsburgh, PA.

Under the traditional paradigm, the interests of quality and compliance are divergent. Compliance is a risk-averse function, looking to protect the healthcare organization from litigation, public relations problems, and audit failures. Quality, by contrast, is focused on improvement of patient care. These separate functions and paths can contribute to a siloed mentality.

So, if a patient is harmed due to medical error, compliance would look for nonadherence to a process or policy and conduct an investigation to assess the level of liability exposure to help mitigate future loss. A quality investigation, however, would look for lessons that can be learned and ways in which patient care can be improved so that the patients are better served.

This traditional paradigm no longer applies. Quality and compliance work with each other and with other departments across the hospital. Like compliance, quality is something that requires commitment from many different teams, including hospital leaders, providers, and employees. And a robust quality program helps support compliance objectives.

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