Or. Admin. Code § 333-076-1020

Current through Register Vol. 63, No. 11, November 1, 2024

Section 333-076-1020 - ESC Quality Assessment and Performance Improvement

(1) The governing body of an ESC must ensure that there is an effective, facility-wide quality assessment and performance improvement program that demonstrates measurable improvement in patient health outcomes, and improves patient safety by using quality indicators or performance measures associated with improved health outcomes and by the identification and reduction of medical errors.

(2) The ESC must measure, analyze, and track quality indicators, adverse patient events, infection control and other aspects of performance that includes care and services furnished in the ESC. Written documentation of quality assessment and performance improvement activities shall be recorded at least quarterly.

(3) After an analysis of the causes for adverse events, the ESC must develop and implement facility-wide preventive strategies and ensure that staff are trained in and familiar with these strategies.

(4) The ESC must set priorities for its performance improvement activities that:

(a) Focus on high risk, high volume and problem prone areas;

(b) Consider incidence, prevalence and severity of problems in those areas; and

(c) Affect health outcomes, patient safety and quality of care.

Or. Admin. Code § 333-076-1020

PH 1-2019, adopt filed 01/07/2019, effective 1/7/2019

Statutory/Other Authority: ORS 441.025 & OL 2018 Chapter 50

Statutes/Other Implemented: ORS 441.025 & OL 2018 Chapter 50