Legal Issues Faced by Quality Managers Essay

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Introduction

This paper will look at the legal issues that medical quality managers face in their line of work. Medical regulatory and accreditation institutions have developed a formidable legal framework to govern medical service provisions. The laws also protect patients seeking medical services from medical malpractice by physicians. Medical quality managers must learn and apply legal regulations and ensure quality standards are maintained in the institutions.

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Medical institutions operate within set legal standards; quality managers in these institutions are tasked to ensure the legal standards are adhered to. The standards are maintained by adopting working practices that promote “quality care as well as enforcing behavior changes whenever it is necessary” (American College of Medical Quality, 2005, p.186). Medical quality managers use legal standards as a tool to influence professional ethics among medical practitioners and the entire medical fraternity.

The whole process of provision of medical service brings together a number of players. They include; medical practitioners, medical regulatory bodies, medical service consumers or patients, and medical suppliers (Hoyle, 2007, p. 81). Each of these players presents varied demands and preferences to the institution. Medical quality managers apply legal structures to create a balance among each of the preferences and demands presented to them (American College of Medical Quality, 2005, p. 189).

Medical service provision requires both financial and administrative support; risk and liability management in this process should be footed on well-established legal structures. The legal structures provide for certification and accreditation of medical practitioners and ensure they are well trained and qualified to carry out such duties before they are allowed to practice. Accreditation and regulation laws require compliance to set legal standards to provide financial aid to an institution: “Medicare and Medicaid provide financial aid” only to hospitals that comply with accreditation regulations (Varkey, 2010, p.26).

Insurance medical plans are run in legal frameworks that medical quality managers have to integrate into the hospital operation system. Incidentally, every state in the US has had different health care regulations. Some states require ascertaining the quality of medical service provided by particular health care institutions before issuing a certificate of authority. Under federal laws, a medical plan qualifies to take part in Medicaid and Medicare if it is currently under a quality and performance appraisal scheme. The quality managers should ensure that quality assessment and performance appraisal programs are carried out in their institutions to the requirements of the federal law.

Besides the federal and state accreditation regulations, medical institutions are also required to follow the regulations of the licenses. Sometimes, either due to convenience or shortages, medical institutions have had to face legal tussles resulting from negligence by contracted physicians. Private or independent doctors are often employed by hospitals to offer part-time medical services to patients. Quality managers have a responsibility to ensure that everyone in the institution follows the regulations of all regulatory bodies in the medical services industry (Sanbar, 2004, p.189). This is irrespective of whether such people are permanently employed by the organization or are serving on a temporary basis.

It is important that quality managers understand the legal frameworks and are able to apply them accurately to govern their institutions. They also need to seek legal advice from legal experts on how well to resolve some of the legal issues they may encounter in their daily activities. Quality managers should ensure all workers in their institutions are familiar with the standards set by regulations set out by various regulatory bodies within the medical services industry (Hoyle, 2007, p. 81). Quality managers should attend to the problem as they come up and avoid postponement. A postponed problem can spread the problem effect to more parties.

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Conclusion

Quality managers in the medical services industry face a number of legal and ethical issues as they supervise service delivery. Resolving these issues requires creativity and clear understanding of the legal matters that govern the medical field. Quality managers need to be vigilant to ensure their institutions are protected from legal proceedings.

Reference List

  1. American College of Medical Quality. (2005). Core curriculum for medical quality management. Massachusetts: Jones and Bartlett Publishers.
  2. Hoyle, D. (2007). Quality Management Essentials. Burlington: Elsevier.
  3. Sanbar, S., S. (2004). Legal medicine. Philadelphia: Mosby, Inc.
  4. Varkey, P. (2010). Medical Quality Management: Theory and Practice. Massachusetts: Jones and Bartlett Publishers.
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IvyPanda. (2021) 'Legal Issues Faced by Quality Managers'. 23 December.

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IvyPanda. 2021. "Legal Issues Faced by Quality Managers." December 23, 2021. https://ivypanda.com/essays/legal-issues-faced-by-quality-managers/.

1. IvyPanda. "Legal Issues Faced by Quality Managers." December 23, 2021. https://ivypanda.com/essays/legal-issues-faced-by-quality-managers/.


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IvyPanda. "Legal Issues Faced by Quality Managers." December 23, 2021. https://ivypanda.com/essays/legal-issues-faced-by-quality-managers/.

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