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January 25, 2023

Quality vs Compliance in Healthcare: What's the Difference?

Healthcare administrators and hospital staff are all aware of the importance of compliance in our industry. Keeping up to date with relevant regulations is essential for maintaining accreditation and ensuring reimbursement. However, the careful monitoring of compliance can lead us to confuse it with the delivery of high quality care—a costly misstep along the way when striving towards patient satisfaction and positive outcomes. 

In this post, we'll explore how healthcare compliance and quality are related but often confused, and how providers and administrators can better differentiate between the two while continuing their efforts towards both advancing compliant operations and providing excellence in care delivery.

Compliance in healthcare is about following the rules and regulations set by governing bodies

Compliance can be a loaded word in the healthcare field. We often think of it in relation to insurance reimbursement. Are we compliant with billing and coding requirements? Are we maintaining our accreditations, a requirement for reimbursement in some specialities? Regulatory compliance is another form of compliance. This type of compliance keeps healthcare organizations in line with regulations that exist as the minimum for safety. 

Quality in healthcare is about providing the best possible care to patients

There is a minimum expectation that all patients should have of receiving safe care that is in line with best clinical practices. But is that equivalent to high-quality care? 

In no field is doing the bare minimum considered high quality.

In school, doing the minimum was equivalent to “not failing.” As healthcare professionals, most of us hold ourselves to a much higher standard, and that personal passion and motivation is what contributes to the kind of patient care that doesn’t just meet the standard, but exceeds it. 

As an example, in radiation oncology, we understand the standards and abide by them, because that’s the expectation and requirement for safety. But I’ve also been lucky enough to know plenty of radiation oncologists and therapists who don’t spend their days meeting the basic standards, but instead, ask questions like, “What if we could get optimal results with an even lower dose to the normal tissue?” or in Radiology,  “Could we do some prep work ahead of time so that the time the patient spends on the imaging table is minimized?”

That’s an illustration of striving for quality–a mindset that puts the patient first. 

Quality improvement is a continuous process, while compliance is an event-based approach

Compliance is critical, but it is often a time-limited effort. We scramble to get ready for inspection, and then breathe a sigh of relief once the scramble is over and the hospital is accredited for another three years, or the department has passed for another year. Quality, however, has no start and finish. It’s an ongoing effort. 

When I was working as a student X-ray tech I began to really focus on making the images I took the very best they could be. As I learned more about the equipment and field, my intent shifted from simply doing the job to offering the radiologist the very best images possible.

One of my proudest moments in that job was when a patient came in for a scan, a very large man who’d suffered an injury in a bicycle accident coming home from a party. His size was a problem because he didn’t fit in the CT scanner. 

At that point in time, we had tomography machines, and since the CAT Scan is computed tomography, I knew it would be possible to take an image on the tomography table instead. The patient came from the ICU, so he had all kinds of attachments and tubes, and was in a crazy bed, and it wasn’t easy to get him on the table, on his side to take a lateral tomographic image. 

However, because I really understood how the tomography machine worked and how best to position the patient, I was able to get the images. Not only did the radiologist get the images she needed, but she sent me a note telling me that they were the best C7 tomographic images she had ever seen. 

Quality creates better outcomes and a more motivated workforce

That single experience, and the recognition I received afterwards, motivated me to work harder, to continue building my knowledge and using it to deliver the very best I could each day. The understanding of how I’d helped that patient and the radiologist, of how my work fit into the overall patient outcome, gave me tremendous satisfaction. 

If everyone in the hospital pushed themselves that way, and if we all did our best to recognize the hard work of others, we’d have a tremendously satisfied and high-performing workforce. It really seems like quality begets quality. The radiologist in my example went above and beyond to recognize my efforts, and I’d gone above and beyond for the patient. That’s the definition of quality, I think: doing more than what is expected. 

Quality and Compliance Work Together to Provide Optimal Patient Outcomes

Quality is an essential element of healthcare, and compliance plays a vital role in achieving it. But without an emphasis on quality improvement, compliance is not enough. If the goal of healthcare is to achieve the very best patient outcomes possible, then practitioners should be looking for ways to improve processes and workflows to allow for more time spent optimizing patient care. By constantly striving to improve quality above the minimum regulatory requirements for safety, we ensure that our own job satisfaction and our patient outcomes are the best they can be. 

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In the near future, Enzee’s platform will provide the same features from radiology and radiation oncology to the entire hospital equipment QA program and also connect to existing compliance and test tracking apps, providing a holistic picture of a facility’s compliance and quality across personnel and departments.