I’m always intrigued (and sometimes confused) by the poll question that appears in the upper right hand corner of this site. Todays is: “Are you satisfied with your facility’s quality assurance program? How might it be improved?” Well, are we talking here about quality assurance? Or quality management? And what’s the difference? And, if you have the latter, do you really need the former? I see quality assurance as a process whereby one attempts, after the fact, to determine what went wrong. I see quality management as a process whereby leadership attempts to keep things from going wrong in the first place. It’s data-driven, staff-empowered and customer-focused. While quality assurance might have a role to play, I would suggest that it’s only as one of a number of data sets designed to feed the quality management process itself. It’s kind of like mock surveys – something else I’ve never really been a fan of. What’s the good of discovering deficiencies after the fact (even if you catch them before the surveyors arrive)? Better to have a quality management system in place that will help avoid them in the first place. And before you jump on me as a misguided academic who’s never had to manage a community, let me assure you that the thought came to me from a respected colleague who’s run more than her fair share of deficiency-free facilities. But, let’s talk about it!