Which of the following conclusions were made when Congress asked for a report on the federal government's quality enhancement process on the care the federal government gave? (Select all that apply.)
a. A clear responsibility at the federal level is to lead by example.
b. Computerized clinical data have enabled practice guidelines to be written.
c. Federally sponsored education and training programs have a strong impact.
d. Quality assurance information has been consistent and useful in improvement.
e. The quality of federal health care was very good.
f.
Writing regulations influences nonfederal health care providers and organizations.
ANS: A, C, F
The report Leadership by Example concluded that there is a lack of consistent performance measurement, the information is not useful, computerized clinical data are missing, and the approach to gathering data is not systematic. The federal government is the largest purchaser of care because it gives direct care to specified groups and requires conforming to regulations for those accepting Medicare and Medicaid funds. Sponsored research, education, and training also have an impact. The report concluded that the federal government must accept leadership both by example and by coordinating improvement in health care quality.
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