The University of Cincinnati Ambulatory Care Services management tam developed a Quality Assurance (QA) Orientation Manual including forms used to implement their QA program. This QA Orientation Manual was completed in December 1990. At that time, the JCAHO began moving toward the concept of Continuous Quality Improvement (CQI), which was reflected in the Accreditation Manual for Hospitals, 1992. While “thresholds” were developed as part of the QA Orientation Manual, “goals” are more appropriate to the CQI process. With quality assurance, thresholds are determined, and exceptions to the thresholds are reported. Consequently, quality assurance becomes a report of exceptions to the established thresholds. In comparison, in CQI, goals are established and measurements of consistent improvement toward the goals are reported. Thus, the goals become synonymous with the accepted standards of care.