How Interpretive Guidance Shapes Compliance

Please note that this newsletter applies to all accredited QUAD A programs.

Interpretive Guidance (IG) serves as an important tool to help facilities better understand and apply QUAD A standards with clarity and confidence.

Purpose of Interpretive Guidance 

Interpretive Guidance (IG) is provided to support the understanding and application of QUAD A standards. IGs are explanatory tools, not requirements, and are not used as scorable elements during the accreditation process. While IGs provide valuable context, practical examples, and insights into the intent behind each standard, they are not themselves requirements.

Instead, they act as supportive resources that strengthen comprehension, promote consistency among surveyors, and assist facilities as they align their policies and procedures with QUAD A’s expectations for safety and quality. By offering illustrative—not mandatory—approaches, IGs enhance a facility’s ability to demonstrate compliance in a variety of ways that best fit its operations. 

Interpretive Guidance is intended to:

• Clarify the intent of a standard by explaining the underlying objectives related to patient safety and quality. 

• Offer examples of acceptable methods, processes, or documentation that a facility may use to demonstrate compliance. These examples are illustrative and not mandatory. 

• Promote consistency among surveyors by identifying common areas of review and evidence gathering related to the standard. 
• Encourage continuous improvement as facilities assess their policies and procedures in relation to the goals of the standard.
  

Use of IGs in the Accreditation Process

Interpretive Guidance supplements the standards but does not function as an additional layer of requirements. Accreditation decisions are based solely on a facility’s compliance with the published QUAD A standards. 

• IG examples are not scoreable and cannot be used as the basis for a citation. 

• A facility may demonstrate compliance through methods other than those listed in an IG, as long as the approach meets the requirements of the standard. 

• Conversely, mirroring an IG example does not guarantee compliance if the underlying standard is not effectively met or implemented.
  

Survey Application

During the on-site survey:

• The Standard Serves as the Benchmark 
  Surveyors evaluate compliance directly against the language of the standard.
• The IG Informs the Review Process 
  Surveyors use IGs to guide their inquiry, including selecting relevant questions and identifying appropriate sources of evidence. 
  
  Example: If a standard requires a “qualified circulator,” the IG may suggest reviewing credentials or competency assessments. Evidence of qualifications may be demonstrated through personnel files, competency documentation, or other facility-established methods.
• Compliance Is Evidence-Based 
  The surveyor determines compliance by assessing whether the evidence provided—regardless of format—meets the requirement described in the standard. 

Interpretive Guidance plays a vital role in the accreditation process by helping both facilities and surveyors approach QUAD A standards with a shared understanding of their purpose and intent. However, IGs do not replace or augment the standards themselves; compliance is always determined solely by the evidence presented in relation to the published standard requirements.

By using IGs as informative tools rather than prescriptive directives, facilities can strengthen their quality and safety practices while maintaining flexibility in how they meet each standard. Ultimately, IGs support consistent, evidence-based evaluations and encourage continuous improvement across accredited organizations.

Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.