Sample Description Advanced Practice Registered Nurse (APRN) students at Frontier Nursing University (FNU) conducted a quality analysis survey of 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 suburban. A wide variety of clinical care models are represented in this survey. Two (50%) of these sites are midwife-led or APRN-led clinics where care is provided by APRNs/midwives unless the client requests a medical consultation. One (25%) of the practices is a shared practice model where care is provided by midwives/APRNs and physicians, however workloads are clearly distinct between providers. The other clinic (25%) is a combined practice model where care is provided in collaboration with physicians, so that women can receive care from midwives/APRNs or physicians, regardless of their risk status or medical needs. In reference to the Commission on Accreditation of Birth Centers (CABC) and Joint Commission (JC) standards, two (50%) out of four sites comply with the standards. The midwife/APRN-led model located in an urban community-based hospital in Iowa had the highest quality improvement/assurance rating among this group. (194) CABC Standards Regarding compliance with CABC standards, only half (50%) of the sites examined met the standards and 50% did not. Centers that met the standard (50%) had conducted a provider or interdisciplinary team meeting focused on clinical issues including literature review, evidence-based guidelines, and four to eight chart or case reviews… ... half of the document... ...nt standard for the identified problem. The collaborative model of care will be established across the site. This model of care involves all providers and corresponding patient advisors meeting a few times a year with the goal of meeting the healthcare needs of their patients. Collaboration will facilitate quality and knowledge improvement through sharing expertise (Health Resource and Service Administration (HRCA), 2011; Area Health Education Center (AHEC), n.d.) (91) Conclusion An effective quality assurance and improvement program ensures improvement of quality of life and quality of life. patient care. The success of the intended outcomes depends on each member of the healthcare team. The standard of care established by CABC, JC and other commissions will guide institutions to establish standards, set goals and find tools to improve patient care.