Quality Assurance Implementation Concerns Medicine Research (Essay Sample)

Quality Assurance Implementation Concerns
Student’s Name:
Institution:
Factors that could inhibit implementation of a QA (Quality Assurance) program at the Hospital.
Clinical Reminder Systems: The systems require a rapid response time, available computer equipment as well as enough expert know-how of the software to be attainable for use throughout repetition hours. Their association with heightened patient consequences remains unevaluated (N.Lohr, 1990).
* Accreditation for Organizations: Accreditation is evidence which certain efforts of quality assurance like staffing policies, grievance procedures pursued or requiring specific credentials (N.Lohr, 1990).
* Generic Screening: It is ineffectual in detecting quality problems. For instance, reports of the proportion of cases which are unsuccessful after the initial screens and should be reviewed further range from 14% to 30%. Only a portion of those cases would be revealed to possess true quality problems (N.Lohr, 1990).
* Outcome Data: Rates of hospital-specific mortality are further limited in their utility unless they use lots of patients from each hospital, many hospitals, changes in the main characteristics of a hospital, and comparison over time to diminish the difference in the outcome of chance (N.Lohr, 1990).
* Health Status Assessment: Comparing expected health with observed health needs empirical data on the illness natural history as well as on the treatment effects. Information like this is yet missing for numerous illnesses. More important, connecting lower-than-expected health condition to a deficient as well as recognizable care elements is frequently challenging and limits the outcome-based techniques’ value for quality valuation (N.Lohr, 1990).
* Licensure: Board Certification and Licensure are of significance. After the moment licensure has been acquired, the power to practice medicine is only legally constrained by medical and criminal malpractice law. Licensure of a physician is usually for life, and in case of a license renewal, no new competence demonstration is needed. Numerous states have introduced certain CME (Continuing Medical Education) necessities as a license renewal condition (N.Lohr, 1990).
* Clinical Indicators: Reports of patients are prone to error in survey methods, like favoritism because of non-response by persuaded population subgroups as well as mistakes in recollection. General queries enquiring about gratification characteristically lead to inflated patient evaluation in contrast to particular questions. The patients’ inability or ability to magistrate practical maintenance excellence is also a challenge as is regarding for the ill effect and the health care environment effect on patient’s valuation (N.Lohr, 1990).
* Appropriateness and Patient Management Guidelines: Guidelines are commonly implemented without or only haphazard evaluation or pretesting. Frequently they lack requirements for bringing up-to-date or adjustment grounded on new familiarity, on their effectiveness to clinicians, or on their effect on care. For patients possessing multiple chronic conditions, guidelines might be of restricted use due to the fact that the formats quickly turn out to be too multifaceted for easy reference (N.Lohr, 1990).
* Retrospective Evaluation of Process of Care: The criteria and standards development needs efficacy evidence or at least effectiveness. Retrospective evaluation, which is generally grounded on medical record appraisal for cost reasons, unobtrusiveness and practicability, is subject to medical record review eminent limitations (N.Lohr, 1990).
* Use of Large Administrative Data Sets: For quality valuation, administrative databases are believed to possess considerable drawbacks. For instance, databases might exclude crucial information like information on service and provider location, cost or certain events, and might accumulate them in a manner which obfuscates connection to other files (N.Lohr, 1990). 
Defense Mechanisms are:
* Displacement: Redirecting emotions to another goal (Freud, 1985).
* Denial: Believing/claiming that what happens to be true to be in fact false (Freud, 1985)
* Projection: Ascribing painful feelings for others (Freud, 1985).
* Intellectualization: Take an impartial perspective (Freud, 1985).
* Rationalization: Developing false but reasonable explanations (Freud, 1985).
* Regression: Getting back to behaving like a kid (Freud, 1985).
* Reaction Formation: Exaggerating in the contradictory way to the panic (Freud, 1985).
* Sublimation: Redirecting ‘wrong’ wishes into publicly tolerable activities (Freud, 1985).
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