QUALITY ASSURANCE PROGRAMS

In addition to ethics committees, most hospitals and healthcare agencies have a quality assurance (QA) program. These programs were established in the early 1960s as a response to the increasing demand from the public for accountability in quality medical care. Quality assurance (QA) is gathering and evaluating information about the services provided, as well as the results achieved, and comparing this information with an accepted standard.

Quality assessment measures consist of formal, systematic evaluations of overall patient care. After the results of the evaluations are compared to standard results, any deficiencies are noted and recommendations for improvements are made ( Figure 1.3 ). The types of issues that are reviewed by a QA committee are:

Figure 1.3 Quality Assurance Committee Meeting

· Patient complaints relating to confidentiality.

· Errors in dispensing medications.

· Errors in labeling of laboratory specimens.

· Adverse reactions to treatments and/or medications.

· Inability to obtain venous blood on the first attempt.

· Safety and monitoring practices for radiology and laboratory areas.

· Infection control.

MEDICAL ETIQUETTE

There are certain rules of medical etiquette , or standards of professional behavior, that physicians practice in their relationship and conduct with patients and other physicians. These are general points of behavior and are not generally considered to be medical ethics issues. For instance, physicians expect that their telephone calls to fellow physicians will be taken promptly and that they will be seen immediately when visiting a physician’s office. This courtesy is extended to physicians because they are often consulting about patients with other physicians. However, ethical issues are present when one physician overlooks or “covers up” the medical deficiencies of another physician.

In addition, physicians should be referred to as “Doctor” unless they request to be called by their first name. The same courtesy is required for the patient. Many patients, especially the elderly, prefer to be addressed by their surname (with Ms., Miss, Mrs., or Mr.). Many nurses and other allied health professionals prefer to be addressed in this manner also. There are allied healthcare professionals who have decades of experience and do not wish to be addressed by either the patient or physician by their first name.