2. Health Care Environment Flashcards
type of health care that mainly focuses on health equity producing social policy beyond the traditional healthcare system. Its main aim is to provide local care to a patient.
Primary Healthcare
this healthcare is provided by the medical specialists and other health professionals who do not have direct contact with a patient like urologists, dermatologists, cardiologists etc.
Secondary Healthcare
this type of healthcare is known as specialized consultative healthcare usually for inpatients and on referral from primary and secondary healthcare for advanced medical investigation and treatment.
Examples are plastic surgery, burn treatment, cardiac surgery, cancer management, neurosurgery, complex medical and surgical interventions etc.
Tertiary Healthcare
hospitals that do not have overnight patients are usually referred to as
Clinics
Culture and religion were linked into medicine.
Ancient Time
Temples of Saturn, and later of Asclepius, were recognized as healing centers.
Ancient Time
King Ashoka established a chain of hospitals in Hindustan
230 BC
Romans established hospitals (valetudinaria) for treatment of injured soldiers
100 BC
Roman Emperor Constantine I (Constantine the Great) established the modern concept of hospital
331 AD
The Christian tradition emphasized the close relationship of the sufferer to the members of the community
331 AD
St. Basil the Great established religious foundation in Cappadocia that included a hospital, an isolation unit for those suffering from leprosy
370 AD
St. Benedict of Nursia at Montecassino, founded a hospital where the care of the sick was placed above and before every other Christian duty
6th Century
Religion continued to be the dominant influence in the establishment of hospitals during the Middle Ages
6th Century
Pestilence and disease killed crusaders
11th Century
Hospitallers of the Order of St. John established a hospital that can cater 2000 patients in the Holy Land - later known as St. John Ambulance
1099
Arab hospitals in Baghdad and Damascus and in Cordoba in Spain admitted patients regardless of religious belief, race or social order.
12th Century
Hospital of the Holy Ghost was founded at Montpellier France – became one of the most important centers in Europe for Training Doctors
1145
The middle Ages also saw the beginnings of support for hospital-like institution by secular authorities
1145
Henry VIII stopped building hospitals in England
1540
Voluntary Hospitals were established
1540
First Hospital in North America (Hospital de Jesus Nazareno) was built in Mexico City by Hernan Cortes
1524
First Hospital in North America
Hospital de Jesus Nazareno
Roman Emperor Constantine I
Constantine the Great
Romans established hospitals
Valetudinaria
Who built the first Hospital in North America, Mexico City.
Hernan Cortes
First incorporated hospital in America was the Pennsylvania Hospital in Philadelphia which obtained a charter from the crown.
1751
First incorporated hospital in America, Philadelphia; which obtained a charter from the crown.
Pennsylvania Hospital
established hospitals in the Philippines
Spanish Government and Missionaries
first hospital was erected by______ in Cebu on 1565 that was later transferred to Manila for the purpose of treating sick and wounded military.
Spaniards
The first hospital was erected by the Spaniards in Cebu during
1565
Early hospitals in the Philippines were established by
Franciscans
Brotherhood of the Misericordia, Brotherhood of
San Juan de Dios, and the Dominicans
Franciscans
San Lazaro hospital was established in
1578
Subject: Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Institution
DOH Administrative Order No. 2012 – 0012
A hospital which is owned by a government and receives government funding. This type of hospital provides medical care free of charge, the cost of which is covered by the funding the hospital receives.
Public Hospital /
Governmental Hospital
A hospital owned by a for-profit company or a non-profit organization and privately funded through payment for medical services by patients themselves, by insurers, or by foreign embassies.
Private Hospital
is the central health care facility within its geographical region.
District Hospital
have a large capacity for intensive care and long-term care. Specialized centers for surgery, plastic surgery, obstetrics, and laboratories will also be available.
District Hospital
trauma centers, rehabilitation hospitals, children’s hospitals, geriatric hospitals, psychiatric hospitals. Specific hospitals for cardiology, oncology, orthopedics, etc. These are typically part of a large hospital or hospital network. They are often located on the hospital campus or nearby.
Specialized Hospital
combines assistance to patients with teaching to medical students and nurses and often is linked to a medical school or nursing school.
Some hospitals are affiliated with a university, college, medical school, or nursing school and offer health care to patients while teaching medical students, physicians, surgeons, and nurses.
Teaching Hospital
are unique in that they employ physician residents who are in training and work hand in hand with local medical schools. The physician residents are overseen by chief medical residents as well as department chairs of
the various medical specialties.
Teaching Hospital
generally provide outpatient care only and are smaller than a typical hospital. Are usually operated by a government health agency or a partnership of private physicians and/or surgeons.
Clinic
Inpatient, outpatient and day patient, Emergency and elective, Rehabilitation
Patient Care
Vocational, Undergraduate, Postgraduate, Continuing education
Teaching
Basic research, Clinical research, Health services research, Educational research
Research
Source for referrals, Professional leadership, Base for outreach activities, Management of primary care
Health System Support
Inside hospital - Health professionals, other health care workers; Outside hospital - Suppliers, Transport services
Employment
State legitimacy, Political symbol, Provider of social care, Base for medical power, Civic pride
Societal
Types of Healthcare
Primary, Secondary, Tertiary
Types of Hospitals
Public, Private, District, Specialized, Teaching, Clinic
Functions of Hospitals
Patient Care, Teaching, Research, Health System Support, Employment, Societal
also known as mental hospitals, mental health units, mental asylums or simply asylums,
are hospitals or wards specializing in the treatment of serious mental disorders, such as clinical depression, schizophrenia, and bipolar disorder.
Psychiatric Hospital
Long Term/ Residential Care Facility
Board and Care Homes, Assisted Living, Nursing Homes, Continuing Care Retirement Communities
also called residential care facilities or group homes, are small private facilities, usually with 20 or fewer residents. Rooms may be private or shared. Residents receive personal care and meals and have staff available around the clock. Nursing and medical care usually are not provided on site.
Board and Care Homes
is for people who need help with daily care, but not as much help as a nursing home provides. Typically, a few “levels of care” are offered, with residents paying more for higher levels of care. usually live in their own apartments or rooms and share common areas.
Assisted Living
also called skilled nursing facilities, provide a wide range of health and personal care services. Their services focus on medical care more than most assisted living facilities. Some people stay at a nursing home for a short time after being in the hospital. After they recover, they go home. Rehabilitation services, such as physical, occupational, and speech therapy, are also available.
Nursing Homes
also called life care communities, offer different levels of service in one location. Many of them offer independent housing (houses or apartments), assisted living, and skilled nursing care all on one campus. Healthcare services and recreation programs are also provided.
Continuing Care Retirement Communities
is specialized type of care for those facing a life-limiting illness
Hospice
addresses the patient’s physical, emotional, social and spiritual needs. It also helps the patient’s family caregivers. It takes place in the patient’s home or in a home-like setting.
It concentrates on managing a patient’s pain and other symptoms so that the patient may live as comfortable as possible and make the most of the time that remains.
Hospice Care
It is founded on a belief that the quality of life to be as important as length of life
Hospice
is a type of care and philosophy of care that focuses on the palliation of a chronically ill, terminally ill or seriously ill patient’s pain and symptoms, and attending to their emotional and spiritual needs.
Hospice care
were places of hospitality for the sick, wounded, or dying, as well as those for travelers and pilgrims.
Hospice
The first modern hospice care was created by _________ in _______ .
Cicely Saunders, 1967
medical care provided on an outpatient basis, including diagnosis,
observation, consultation, treatment, intervention, and rehabilitation services. This care can include advanced medical
technology and procedures even when provided outside of hospitals.
Out-patient /
Ambulatory Care
is any same-day medical procedure performed in an outpatient setting. This refers to any medical service that is not performed in a hospital or facility that requires admission.
Ambulatory Care
Four Smaller Sub-Categories of Ambulatory Care
Wellness, Diagnosis, Treatment, Rehabilitation
This is normally what you think of when you imagine going to the doctor.
are mostly for prevention and basic medical care. They include doctor’s clinics, such as primary care, as well as counselling centers for mental health and weight loss.
Wellness
can be provided on their own, or as part of a wellness or treatment program. They
include X-Rays, lab and blood tests, MRIs and screening for various cancers and illnesses.
Diagnosis
These include same-day surgery centers, substance abuse clinics, chemotherapy and other forms of therapy.
Treatment
includes post-operative therapies, occupational and physical therapy and rehab for drug and alcohol abuse.
Rehabilitation
ambulatory care encompasses newer forms of healthcare, such as
Telemedicine
allows doctors and nurses to “see” and interact with patients via email, phone and video chatting. _______ , BSN RN, uses it to assess her patients.
Telemedicine, Amelia Roberts
alternately preventive medicine, preventative healthcare/medicine, or prophylaxis
Preventive healthcare
consists of measures taken for disease prevention, as opposed to disease treatment. Just as health comprises a variety of physical and mental states, so do disease and disability, which are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices. Health, disease, and disability are dynamic processes which begin before individuals realize they are affected.
Preventive healthcare
relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.
Disease prevention
Levels of Preventive Health Care
Primal and Primordial Prevention, Primary Prevention, Secondary Prevention, Tertiary Prevention, Quaternary Prevention
Any measure aimed at helping future parents provide their upcoming child with adequate attention,
as well as secure physical and affective environments from conception to first birthday (i.e., refers to measures designed to avoid the development of risk factors in the first place, early in life.
Primal and Primordial Prevention
Methods to avoid occurrence of disease either through eliminating disease agents or increasing resistance to disease.
Examples include immunization against disease, maintaining a healthy diet and exercise regimen, and avoiding smoking.
Primary Prevention
Methods to detect and address an existing disease prior to the appearance of symptoms.
Examples include treatment of hypertension (a risk factor for many cardiovascular diseases), cancer screenings
Secondary Prevention
Methods to reduce the harm of symptomatic disease, such as disability or death, through rehabilitation and treatment.
Examples include surgical procedures that halt the spread or progression of disease
Tertiary Prevention
Methods to mitigate or avoid results of unnecessary or excessive interventions in the health system
Quaternary Prevention
is a wide range of health care services that can be given in patient's home for an illness or injury. is usually less expensive, more convenient, and just as effective as the care received in a hospital or skilled nursing facility (SNF).
Home Health Care
Examples of skilled home health services
- Wound care for pressure sores or a surgical wound
- Patient and caregiver education
- Intravenous or nutrition therapy
- Injections
- Monitoring serious illness and unstable health status
In general, the goal of home health care is to treat an illness or injury. Where possible, home health care helps the patient:
- Get better
- Regain their independence
- Become as self-sufficient as possible
- Help patients maintain their current condition or level of function and slow decline
Examples of what the home health staff should do:
- Check what the patient is eating and drinking.
- Check the blood pressure, temperature, heart rate, and breathing.
- Check that the patient is taking his or her prescription and other drugs and any treatments correctly.
- Ask if the patient is having pain.
- Check the patient safety in their home.
- Teach them about the care so they can take care of themselves.
- Coordinate the care. This means health staffs must communicate regularly with the patient, the doctor, and anyone else who gives the patient care.
is the remote delivery of healthcare services, such as health assessments or consultations, over the telecommunications infrastructure.
It allows healthcare providers to evaluate, diagnose and treat patients without the need for an in-person visit.
Telemedicine
The first example of an electronic medical record transfer occurred in
1948 in Pennsylvania
When did clinicians at the University of Nebraska transmitted neurological examinations across campus to medical students using two-way interactive television.
1959
In the early days of telemedicine, health professionals used __________ as a way to reach patients living in rural areas.
Burgeoning Technology
physicians at the University of Miami, School of Medicine and Miami’s Fire Department transmitted electrocardiographic rhythms over existing voice radio channels from fire-rescue units to the city’s Jackson Memorial Hospital.
1967
Types of Telemedicine
Remote Patient Monitoring, Store-and-Forward, Interactive Telemedicine
Also known as telemonitoring, remote patient monitoring allows patients with chronic diseases to be monitored in their homes through the use of mobile medical devices that collect data about blood sugar levels, blood pressure or other vital signs. Remote caregivers can review the data instantly.
Remote Patient Monitoring
Also known as asynchronous telemedicine, this telemedicine allows providers to share patient information, such as lab results, with a physician at another location.
Store-and-Forward
allows physicians and patients to communicate in real time. Such sessions can be conducted in the patient’s home or in a nearby medical facility and include telephone conversations or the use of video conferencing software that complies with Health Insurance Portability and Accounting Act regulations.
Interactive Telemedicine
is a subset of telehealth, which includes both remote clinical service delivery and nonclinical elements of the
healthcare system.
Telemedicine
refers to a broader spectrum of remote healthcare services than telemedicine and does not necessarily involve clinical services. It includes nonclinical services such as continuing medical education, provider training and administrative meetings.
Telehealth
In contrast, it refers specifically to the use of medical information exchanged for the purpose of improving a patient’s health. It pertains to the use of electronic communications to provide clinical services without requiring a patient to come in to a doctor’s office.
Telemedicine
considered part of both telemedicine and telehealth.
Technology
Advantages of Telemedicine
Convenience, Increased Access, Reduced cancellations or no-shows, Encourage healthy lifestyle choices,
Disadvantages of Telemedicine
Inability to Prescribe Medications, Technical training and equipment, Licensing issues
Patients do not have to take time away from work for an appointment. There is also no travel time or associated expenses, such as paying for gas or child care.
Convenience
Patients in rural areas can obtain specialty services more easily. Similarly, patients who live in underserved areas have increased access to primary, dental and mental healthcare
Increased Access
Because of its convenience for patients, telemedicine can reduce the
number of cancellations or no-shows. Providers can reach out prior to or at the appointment time if the patient forgot about the appointment.
Reduced Cancellations or No-Shows
Telemedicine allows providers to encourage their patients’ healthy lifestyle choices, such as smoking cessation.
Encourage healthy lifestyle choices
Many states generally do not allow online prescribing (not to be confused with e-prescribing) without an established relationship between the physician and patient. A physical examination or evaluation may be required before a physician can write a prescription for a patient, but there are inconsistencies in state laws as to what constitutes a physical examination
Inability to prescribe medications
Providers need to be trained on how to use telemedicine equipment. There are also the associated costs of the equipment, such as integrated telemedicine carts and encounter management software, to consider. The startup cost of implementing telemedicine may be especially prohibitive to rural facilities.
Technical training and equipment
Certain states may require providers who practice telemedicine across state lines have a valid license in the state where the patient is located.
Licensing issues
