A potential quality issue (PQI) is a suspected deviation from provider performance, clinical care, or outcome of care which requires further investigation to determine if an actual quality of care concern exists.
Gold Coast Health Plan (GCHP) applies a systematic method for the identification, investigation, and reporting of a PQI, to determine opportunities for improvement in the provision of care and services to GCHP members, and to direct appropriate actions for improvement based upon outcome, risk, frequency and severity.
PQIs may be reported by any of the following:
- GCHP staff member
- Any member of the community
- Any contracted or non-contracted provider / staff