The quality assurance process in long-term care focuses on solving resident care problems and monitoring compliance with established standards of practice. An effective quality assurance monitoring system for long-term care includes the audit design steps of study design, criteria development, data retrieval, data interpretation, and definitive action. To assure that a clinical change in nursing practice results from quality assurance audit findings, it is imperative that organizational systems and structures be designed to disseminate these findings and follow through with identified courses of action. A formalized link between the quality assurance committee and nursing administration establishes the legitimate authority and accountability for follow-through to successfully integrate findings into actual practice.