Spironolactone, an anti-androgen, is usually another medication which may be prescribed in along with an oral contraceptive to prevent and treat hormonal acne. It blocks androgen receptors and reduces androgen production in the ovaries and the adrenal glands to avoid excessive oil production. The full total derive from this treatment is, of program, fewer acne flares. Oral contraceptive pills can cause several side effects that can be severe or mild.An extended cohort of 54 products in 9 hospitals showed similar results during the period of 13 months, from September 2008 to October 2009. Participating hospitals showed an 80.5 percent improvement in adherence to CALNOC best practices.4 percent for the study group. They are experienced essential employees, who can identify complications, drive switch, and deliver results. They have the best understanding of recurrent quality issues, so they are best equipped to lead improvement initiatives. And our research shows that they are able to deliver impressive outcomes, when equipped with the right abilities, authority, and executive support. The final data outcomes [Kaiser Permanente Fremont, Kaiser Permanente Hayward, SAN FRANCISCO BAY AREA General Hospital, Sequoia Hospital, St. Rose Hospital, and Stanford Medical Middle] will be published the following month in the December 2009 issue of The Joint Commission Journal on Quality and Patient Safety.