Each supervisory and collaborative agreement must specify a plan for quality assurance management with defined quality outcome measures for evaluation of the clinical practice of the Advanced Practice Practitioner (APP).

Click here for the Supervised Practice Quality Assurance Plan

Click here for the Collaborative Practice Quality Assurance Plan

The physician and APP must set up the criteria by which the physician will be reviewing the records of the APP. There is no set percentage or number of records that should be reviewed but it should be a meaningful sample of the patient records for whom the APP has seen.

QA should be a "look back". At the end of a quarter, the physician and APP decide what criteria they want to look at and pull a meaningful sample of the APP’s patients for that quarter. Someone other than the physician or APP,  who can review those patient records knowledgeably, can formulate a report and the physician and APP can discuss the report, while looking at any patient records that may need improvement.

The physician and APP must document their QA reviews, cite any findings or conclusions, and any recommendations for change moving forward. There must be a patient identifier on the documented QA reviews. The same set of criteria can be used for the next quarter, or changes can be made to the criteria to be reviewed based on any findings that were documented.

Recap:

•              Review a meaningful sample of charts against selected outcome indicators with documentation using a patient identifier.

•              Quarterly meeting to review the QA data (QA data should be readily retrievable).

•              Data can be pulled by anyone with an understanding of the criteria.

•              Chart review does not constitute Quality Assurance Review.

•              Review of charts is a clinical decision between practitioners. The Board’s rules do not require a specific percentage of charts to be reviewed by the supervising/collaborating physician.

Sample QA Forms

These examples are placed here for informational purposes.  Your QA forms do not have to match these.  Use them in whatever way is most helpful to you.

Collective QA Report: UTI Management

Collective QA Report: Hyperlipidemia

Collective QA Report: Prescribed Medications

QA Monitoring Tool for Collaborative Practice

QA Quarterly Audit Summary of Findings

Adverse Event Review