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In the last decade, government and other regulatory agencies have made a dramatic impact on patient care delivery systems. These changes have resulted in the redesign of quality assurance (QA) and quality improvement (QI) programs. The Joint Commission on Accreditation of Healthcare Organization's Agenda for Change and their 10-step method of implementation provide a format for QA and QI activities. In addition, the Peer Review Organization's guidelines and various professional practice standards play an increasingly significant role in defining the continuous improvement of professional practice and patient care. It is important to note that QA is not the same as QI; yet, the two are not mutually exclusive. QA is a methodology whereas QI is a process and a structure that can facilitate the methodology of QA.