1 ATI- Health Care Delivery Systems Flashcards
Health care delivery systems incorporate interactions between _______ and clients withing the constrains of financing mechanisms and regulatory agencies.
health care providers
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.
regulate
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.
service-oriented
Components of Health Care Systems - Participants
Consumers (clients) Providers - licensed providers such as: - RNs - LPNs - APNs - Drs - Pharmacists - Dentists - Dietitians - Physical, respiratory, occupational therapy Unlicensed providers, such as assisstive personnel
Settings of the Health Care Systems - Settings
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
Regulatory Agencies of the health care systems
- 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
_______ is for clients greater than 65 years of age or those with permanent disabilities
medicare
Part A: medicare is for _____.
hospital insurance
Part B: medicare is for ________.
medical insurance
Part C: medicare is for _____
medicare advantage plan
Part D: medicare is for _____.
medications
_____Is for clients who have low incomes. It is federally and state funded. Individual states determine eligibility requirements.
medicaid
______ 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.
Affordable Care act or Obamacare
______ is coverage for uninsured children up to age 19 at low cost to parents
State Children’s Health Insurance Program
Private Plans include managed care organizations (MCOs), preferred provider organizations (PPOs), and exclusive provider organizations (EPOs) and _______.
long term care insurance
____ is used as a supplement for long-term care expenses Medicare does not cover.
long term care insurance
______ focuses on educating and equipping clients to reduce and control risk factors for disease.
preventative health care
______ 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.
primary health care
_______ includes the diagnosis and treatment of acute illness and injury. i.e. hospital settings visits inpatient and emergency, diagnostic centers.
Secondary health care
______________ or acute care, involves the provision of specialized and highly technical cared. i.e. icu, oncology centers, burn centers.
tertiary health care
_____ involves intermediate follow up care for restoring health and promoting self care. i.e home health care, rehabs, skilled nursing facilities
restorative health care
_____ 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
continuing health care
_____ 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.
safety
_____ 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.
patient centered care
________ is the use of current knowledge from research and other credible sources on which to base clinical judgement and client care.
evidence based practice
______ is the the use of information technology as a communication and information gathering tool that supports clinical decision-making and scientifically based nursing practice.
informatics
_____ 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.
quality improvement
______ 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.
teamwork and collaboration
The ultimate issue in designing and delivering health care in the future is ensuring the health and _____ of the population
welfare
