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Clinical Quality Management

The Military Health System (MHS) defines quality in healthcare as "the degree to which healthcare services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." 

DoD 6025.13-R (MHS Quality Assurance Program Regulation) regulates the principles of accountability, continuity of care, quality improvement, and medical readiness. The ultimate goal of the quality assurance program is to ensure the provision of healthcare service is safe and effective.

MHS CQM strives to improve the quality of care, reduce costs, and increase consumer confidence in DoD healthcare delivery. This effort is reflected through:

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DoD Instruction 6025.13: Medical Quality Assurance (MQA) and Clinical Quality Management in the Military Health System (MHS) Instruction


This Department of Defense Instruction (Number 6025.13) establishes DoD policy on issues related to MQA programs and clinical quality management activities.

Competency Assessment File


A competency assessment file (CAF) is used to record information related to individual competence for non-privileged healthcare personnel with patient contact. It is a six-section file (National Stock Number 7530-00-990-8884), or electronic equivalent, similar to that used for Provider Credential Files. It is also known as the 6-sided training folder or Competency Based Orientation File (CBO).

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Clinical Quality Management

Management and Reporting of Clinical Adverse Actions and Professional Misconduct for Privileged Health Care Providers and Non-Privileged Clinical Support Staff


The purpose of this directive is to update and establish policy, assign responsibility, and prescribe procedures for the management and reporting of clinical adverse actions and professional misconduct for privileged health care providers and non-privileged clinical support staff for the Department of the Navy.

DoD Manual 6025.13: Medical Quality Assurance (MQA) and Clinical Quality Management (CQM) in the Military Health System (MHS)


This manual reissues DoD 6025.13-R (Reference (a)) as a DoD manual in accordance with the authority in DoD Directive (DoDD) 5124.02 (Reference (b)) and DoD Instruction (DoDI) 6025.13 (Reference (c)) and the guidance in DoDI 5025.01 (Reference (d)). It implements policy, assigns responsibilities, and provides procedures for managing DoD MQA and clinical quality management.

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