Quality & Accreditation: Incident reporting, audits, indicators and accreditation evidence

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HMS Core

Quality & Accreditation in the Bridge HMS Suite: Incident reporting, audits, indicators and accreditation evidence

What's inside

Everything in Quality & Accreditation

47 items in 8 areas, every one shipping with the app today.

KPI & Quality Indicators
- Hospital Quality KPI LibraryCentral register of quality indicators with name, unique code, unit of measure and full numerator/denominator definitions.
- Seeded 30+ Indicator CatalogShips a preloaded library of 32 globally recognized hospital quality indicators ready to measure out of the box.
- Seven Indicator CategoriesClassifies each KPI as Clinical Quality, Patient Safety, Access/Throughput, Efficiency, Financial, Satisfaction or Staff/Workforce.
- Targets & Traffic-Light ThresholdsEach KPI stores a target plus warning and critical thresholds for automatic status color-coding.
- Direction-Aware ScoringKPIs flag whether higher-is-better or lower-is-better so status is judged correctly for each metric.
- Reporting Frequency GovernanceSets each indicator's cadence as daily, weekly, monthly, quarterly or annually.
KPI Measurement & Analytics
- Period Result CaptureRecords numerator, denominator and period start/end for each KPI reporting window.
- Automatic Rate CalculationComputes the measured value as numerator/denominator x 100, or raw numerator when no denominator is given.
- Automatic Status EvaluationDerives On Target / Warning / Critical status from the value against the KPI's targets and direction.
- Color-coded Measurement ListList view highlights rows green, amber or red by measurement status for instant scanning.
- Facility-Scoped MeasurementsTies each measurement to a hospital facility, defaulting to the user's or company's facility.
- Compiled-By AttributionRecords who compiled each measurement, defaulting to the current user.
Audits & Findings
- Quality & Accreditation AuditsManages audits with reference, title, scope, lead auditor, date, facility and overall score.
- Eight Audit TypesSupports internal, external, mock JCI, mock NABH, SafeCare, mock ISQua, regulatory MoH and peer-review audits.
- Sequenced Audit ReferencesAuto-numbers audits with an AUD/year/nnnn sequence on creation.
- Audit Lifecycle WorkflowDrives audits through Planned, In Progress, Draft Report, Final Report and Closed states via header buttons.
- Standards-Audited LinkingAssociates each audit with the accreditation standards being assessed.
- Embedded Finding RegisterCaptures findings inline on the audit with clause, text, severity, linked CAPA and status.
CAPA Management
- Corrective & Preventive ActionsFull CAPA records capturing root cause, corrective action and preventive action narratives.
- Sequenced CAPA ReferencesAuto-numbers CAPAs with a CAPA/year/nnnn sequence on creation.
- Six-State CAPA LifecycleMoves CAPAs through Draft, In Progress, Awaiting Verification, Effectiveness Check, Closed and Escaped.
- Workflow Action ButtonsHeader buttons start, submit-for-verification, run effectiveness check, close and mark-escaped each CAPA.
- Audit & Finding TraceabilityLinks each CAPA to its originating audit and specific finding for closed-loop traceability.
- Incident Reference LinkingRecords an external incident or event reference that triggered the CAPA.
Accreditation Standards
- Accreditation Standards RegisterCatalog of standards/clauses with title, body-defined code, requirement intent and evidence required.
- Seeded Standards CatalogShips 43 preloaded accreditation standard clauses across multiple bodies.
- Nine Accrediting BodiesCovers JCI, NABH, SafeCare, COHSASA, ISQua, ISO 15189, ISO 9001, CAP and local MoH.
- Edition & Chapter TrackingRecords the standard's version/edition and chapter or section reference.
- Uniqueness EnforcementSQL constraint guarantees each clause code is unique per accrediting body.
- Evidence Requirement DocumentationStores the evidence auditors expect for each standard clause.
Policy & Document Control
- Controlled Policy RegisterManages controlled policy and procedure documents with title, unique document number and version.
- Seeded Policy SetShips 7 preloaded controlled policy documents as a starting library.
- Seven Policy TypesClassifies policies as Clinical, Administrative, Safety, Infection Control, IT, HR or Financial.
- Five-State Document LifecycleDrives documents through Draft, In Review, Approved, In Force and Archived via workflow buttons.
- PDF AttachmentStores the actual policy file as a binary attachment with filename.
- Effective & Review-Due DatesTracks each policy's effective date and next review-due date.
Governance Committees
- Committee Meeting ManagementRecords governance committee meetings with date, chairperson, attendees, agenda and minutes.
- Ten Committee TypesCovers MEC, P&T, Infection Control, M&M, QA/PI, Credentialing, Ethics, Research/IRB, Board and Quality Board.
- Seeded Committee MeetingsShips 14 preloaded committee meeting records as reference/demo data.
- Meeting Status WorkflowMoves meetings through Scheduled, Held, Canceled and Postponed via header buttons.
- Action Item RegisterCaptures inline committee action items with description, responsible owner, due date and status.
- Action Count RollupEach meeting shows a computed count of its action items.
Security & Roles
- Three-Tier Role ModelProvides User, Quality Officer and Quality Manager groups with escalating implied permissions.
- Granular Access RightsUsers get read-only, Officers create/edit, and Managers full delete rights across all eight models.
- Dedicated App CategoryRegisters a Quality & Governance module category to organize the role assignment UI.
- Auto-Grant on InstallPost-install hook grants all three governance groups to administrator users so menus appear immediately.
- Full Chatter & ActivitiesEvery model inherits mail thread and activity mixins for messaging, tracking and scheduled activities.

Works with

What Quality & Accreditation works with

Quality & Accreditation shares one database with the rest of the Bridge HMS Suite and BridgeERP: these are the apps it already talks to, with nothing to buy in between.