Sample DescriptionAdvanced Practice Registered Nurse (APRN) students at Frontier Nursing University (FNU) conducted a quality analysis survey with three (75 %) family nurse practitioner clinics (outpatient practice) and one (25%) nurse midwifery practice (community hospital) in the United States. Among these practices, two (50%) were urban and the other two (50%) were peri-urban. There are a wide variety of clinical care models represented in this survey. Two (50%) of these sites are midwifery or APRN-led clinics where care is provided by APRNs/midwives unless the client requires a medical consultation. One (25%) of the practices is a shared practice model in which care is provided by midwives/APRNs and physicians, but workload is clearly distinguished between providers. The other clinic (25%) is a combined practice model where care is delivered in collaboration with physicians, so women can receive care from midwives/APRNs or physicians regardless of their risk status or their medical needs. In reference to the Commission on Birth Center Accreditation Standards (CABC) and the Joint Commission (JC), two (50%) out of four sites are compliant with the standards. The primary midwife/APRN-led model located in an urban community hospital in Iowa had the highest score for quality improvement/quality assurance within this cohort.(194)Standards CABC Regarding compliance with CABC standards, only half (50%) of the sites surveyed met the standards and 50% did not meet them. Sites that met the standard (50%) had a meeting of providers or interdisciplinary teams focused on clinical issues, including a literature review, evidence-based guidelines, and chart or patient review. cases four to eight...... middle of article... ...nt standards for the problem identified. The collaborative care model will be established across the site. This model of care requires all providers and corresponding patient consultants to meet several times per year with the goal of meeting the health care needs of their patients. Collaboration will facilitate quality and improvement of knowledge through sharing of expertise (Health Resource and Service Administration (HRCA), 2011; Area Health Education Center (AHEC), nd) (91) Conclusion An effective program of assurance and quality improvement program ensures improvement in the quality of life and quality of patient care. The success of the set results depends on each member of the healthcare team. The standards of care established by the CABC, JC and other commissions will guide institutions in establishing standards, setting goals and finding tools to improve patient care..