National Standards for Birth Centers were established to provide a tool for measuring the quality of services provided to childbearing families in birth centers. Quality is a relative term defined by predetermined characteristics, traits, properties, or attributes. Therefore, quality improvement is a continuing process toward achieving the predetermined characteristics, traits, properties or attributes defined by the standards for birth centers.
Quality improvement is an ongoing function that is both external and internal to birth center operation. Licensure and accreditation constitute two arms of external evaluation of quality improvement. Licensing agencies protect the public by monitoring compliance to codes, ordinances and a variety of regulations. This first level of external quality control requires that the birth center meet defined criteria for state licensure in order to operate as a business or health care facility. The level of quality required for licensure, however, may vary from one locality to another. Some states and municipalities are non-specific or uneven in their requirements for regulations while other states may be very specific and uniform in the level of requirements for safe operation.
A second level of external quality evaluation is accreditation. The standards and attributes for accreditation are uniformly applied in all localities, thereby eliminating state and local inconsistency. It is a voluntary program that places the level of quality desired above that which an individual state requires.
The internal quality improvement program is an on-going evaluation by birth center staff and childbearing families. It begins at the earliest stages of planning for a birth center and consists of a systems approach to evaluation of operation and services. With careful planning, new birth centers have the opportunity to build evaluation mechanisms into all facets of the organization and operation from the first day of operation. If attention is given to establishing a strong program of quality management during the planning of the birth center, application for licensure and accreditation are simply a form of external review -an opportunity to be evaluated or measured by established yardsticks for required and desired levels of excellence.