1 ATI- Health Care Delivery Systems

Question 1

Health care delivery systems incorporate interactions between _______ and clients withing the constrains of financing mechanisms and regulatory agencies.

Answer 1

health care providers

Question 2

Health care systems include the clients who participate, the settings in which health care takes place, the agencies that ______ health care, and mechanisms that provide financial support.

Answer 2

regulate

Question 3

Most nurses deliver care within the context of health care systems. As these systems continue to become more business-driven and less ______, the challenge to nursing today is to retain its caring values while practicing within a cost containment structure.

Answer 3

service-oriented

Question 4

Components of Health Care Systems - Participants

Answer 4

Consumers (clients)
Providers
- licensed providers such as:
- RNs
 - LPNs
 - APNs
 - Drs
 - Pharmacists
 - Dentists
 - Dietitians
 - Physical, respiratory,                occupational therapy
Unlicensed providers, such as assisstive personnel

Question 5

Settings of the Health Care Systems - Settings

Answer 5

hospitals
homes
skilled-nursing, assisted living, and extended care facilities
community/health departments
adult day care centers
schools
hospices
providers offices
ambulatory care clinics
occupational health clinics
stand alone surgical centers
urgent care centers
complementary therapy centers

Question 6

Regulatory Agencies of the health care systems

Answer 6

• US Department of HHS
• US FDA
• State and local public health agencies
• State licensing boards to ensure that health care providers and agencies comply with state regulations
• The joint commission to set quality standards for accreditation of health care facilities
• Professional Standards -Review Organiszations to monitor health care services provided
• Utilization review committees to monitor for appropriate diagnosis and treatment of hospitalized clients

Question 7

_______ is for clients greater than 65 years of age or those with permanent disabilities

Answer 7

medicare

Question 8

Part A: medicare is for _____.

Answer 8

hospital insurance

Question 9

Part B: medicare is for ________.

Answer 9

medical insurance

Question 10

Part C: medicare is for _____

Answer 10

medicare advantage plan

Question 11

Part D: medicare is for _____.

Answer 11

medications

Question 12

_____Is for clients who have low incomes. It is federally and state funded. Individual states determine eligibility requirements.

Answer 12

medicaid

Question 13

______ of 2010, is a controversial federal statute aimed at increasing access to health care for all individuals and instituting an individual mandate for health insurance; decreasing health care costs; providing opportunities for uninsured to become insured at an affordable cost.

Answer 13

Affordable Care act or Obamacare

Question 14

______ is coverage for uninsured children up to age 19 at low cost to parents

Answer 14

State Children’s Health Insurance Program

Question 15

Private Plans include managed care organizations (MCOs), preferred provider organizations (PPOs), and exclusive provider organizations (EPOs) and _______.

Answer 15

long term care insurance

Question 16

____ is used as a supplement for long-term care expenses Medicare does not cover.

Answer 16

long term care insurance

Question 17

______ focuses on educating and equipping clients to reduce and control risk factors for disease.

Answer 17

preventative health care

Question 18

______ emphasizes health promotion and includes prenatal and well baby care, family planning nutrition counseling, and disease control. This level of care is a sustained partnership between clients and providers.

Answer 18

primary health care

Question 19

_______ includes the diagnosis and treatment of acute illness and injury. i.e. hospital settings visits inpatient and emergency, diagnostic centers.

Answer 19

Secondary health care

Question 20

______________ or acute care, involves the provision of specialized and highly technical cared. i.e. icu, oncology centers, burn centers.

Answer 20

tertiary health care

Question 21

_____ involves intermediate follow up care for restoring health and promoting self care. i.e home health care, rehabs, skilled nursing facilities

Answer 21

restorative health care

Question 22

_____ addresses long-term or chronic health care needs over a period of time. i.e. end of life care, palliative care, hospice, adult day care

Answer 22

continuing health care

Question 23

_____ is the minimization of risk factors that could cause injury or harm while promoting heigh quality care and maintaing a secure environment for clients, self and others.

Answer 23

safety

Question 24

_____ is the provision of caring and compassionate, culturally sensitive care that addresses client’s physiological, psychological, sociological, spiritual and cultural needs, preferences and values. The client is included in the decision-making process.

Answer 24

patient centered care

Question 25

________ is the use of current knowledge from research and other credible sources on which to base clinical judgement and client care.

Answer 25

evidence based practice

Question 26

______ is the the use of information technology as a communication and information gathering tool that supports clinical decision-making and scientifically based nursing practice.

Answer 26

informatics

Question 27

_____ is care related and organizational processes that involve the development and implementation of a plan to improve health care services and better meet clients’ needs.

Answer 27

quality improvement

Question 28

______ is the delivery of client care in partnership with multidisciplinary members of the health care team to achieve continuity of care and positive client outcomes.

Answer 28

teamwork and collaboration

Question 29

The ultimate issue in designing and delivering health care in the future is ensuring the health and _____ of the population

Answer 29

welfare