Administration Flashcards
Plan of Operation
CTRSs should be concerned with the
1) agency’s plan of operation
2) TR department plan of operation
Agency Plan of Operations
Should include TR services as a component of service.
Includes:
1) Patient management function: client assessments, treatment plans, progress notes, treatment plan and discharge summaries
2) Program management functions: quality improvement, utilization reviews and patient care monitoring
3) Risk Management Plan
TR department plan of operation
Elements:
-Written philosophy, overall goals for the program, and describe the purpose and function of TR in the agency.
-Information related to patient management functions, client assessment protocols, treatment plans, interventions and discharge planning
-Program management functions: staff organization and development, quality improvement, utilization review, and patient care monitoring.
Requirement for RT department as per ATRA Standards of Practice
Therapeutic Recreation Accountability Model (TRAM)
Model that highlights the various accountability and documentation procedures used by the therapeutic recreation specialist to monitor and make decisions about the delivery of services for producing client outcomes.
It ensures that all clients who receive services from the TR department will receive individual treatment plans with propriate program outcomes and client outcomes.
Program evaluation and accountability
Program evaluation is used to determine program effectiveness and to improve services.
Quality of service is delivered, effectiveness of those programs, and the outcomes of those programs are evaluated.
The need to establish an administrative schedule for evaluation and determine the program revision process following data collection for the TR program is attached for the CTRS.
Formative evaluation
Ongoing and occurs while the program is in progress, staff can make changes on a daily or weekly basis depending on what the evaluation data indicates.
Summative evaluation
Conducted at the end of the program and can be used to compare programs or provide information for the next session of programming.
Comprehensive Service Evaluation
Process that focuses on seeking out problematic areas of lower quality, correcting those problems, and evaluating how well those corrections are solving the problems.
Utilization Review
Refers to looking at how effectively a department uses its resources.
It addresses overutilization, underutilization, and inefficiency.
Quality Improvement and guidelines techniques
Utilization review
Risk management
Peer review
Outcome monitoring
Peer Review
A process by which the procedures and results of an experiment are evaluated by other professional who are in the same field or who are conducting similar research.
Outcome Monitoring
The continual measurement and reporting of indicators of the status of the social conditions a program is accountable for improving.
Categories of Outcome Measures
The Joint Commission has identified 3 categories of outcome measures:
health status: functional well-being of an individual
patient perceptions of care: satisfaction measures of care from patient or family perspective
clinical performance outcomes: outcomes of process of care
Quality Improvement
The most common method of evaluating TR services and is mandated by external accreditation agencies
a variety of activities that provide useful data on the quality of care for patients.
Performance Appraisal
Sometimes termed employee evaluations, they are the formal evaluations to indicate how well staff members have performance compared with job standards.
Performance appraisals are conducted with the intent of informing staff members on how well they are meeting performance expectations.
May also reveal staff training and development needs.
Clinical Supervision
A program provided by a master clinician to supervisees that serves the dual process, to improve clinical practice skills of supervisees and to ensure that the therapeutic intents of a program are being provided or met.
Three roles of a clinical supervisor:
teacher
counselor
consultant
Intern Supervision
identify internship goals and objectives
establish policies and procedures
ensure the staff in the facility are prepared to accept interns
develop training materials
establish an intern manual
determine selection procedures
stablish a recruitment plan
Three major tasks an intern supervisor needs to provide: communication with and observation of the intern, documentation of intern activities and experiences, and provision of training and education opportunities.
Volunteers
Department should:
Establish a volunteer plan with policies
Job description
Marketing plan with promotional materials for recruitment and retention.
It is important that program guidelines be established, and that while volunteers may be used for parts of the program, they may not be used for implementation of an intervention.
RTs is still responsible for the assessment, development of program goals, intervention, evaluation, and documentation.
Intern and volunteer management key areas
Recruitment
Supervision
Coordination
Evaluation
Orientation programs
They are necessary to introduce new employees to the agency and the RT unit.
Information typically included in orientation is the history of the organization, along with its vision, purpose, and structure.
In-service training
Helps staff to keep current by updating their skills and knowledge to perform on the job.
Topics may be far ranging, but often involve new client care procedures, learning how to use new equipment, reviewing charting methods, or learning how to use an intervention technique.
Medicaid
-Created by Social Security Amendments in 1965.
-Federal and state program but is administered by state that is designed for qualified needy individuals such as eligible low-income adults, children, pregnant women, elderly adults and people with disabilities.
Pays difference between cost of care and income for those with depleted finances.
Prospective Payment System (PPS)
Established to contain healthcare costs, ensure quality, assure Medicare recipients access to care and it has a beneficiary centered focus.
It is price-based system prices are set in advance, the price is inclusive for all services provided, no additional payment or settlement will occur in the current year’s actual cost, and not impact the price established.
Government Funding
Managed Care
Private Contract
Medicare
Medicaid
Medicare
A federal health insurance program created under the Social Security Amendments in 1965 that provides insurance for those 65+ or people with certain disabilities, and people with end-stage renal disease
4 parts:
Part A provides for: inpatient hospital stays and all listed beneficiaries automatically receive Part A.
Part B provides for: outpatient services ( mostly physicians’ costs) and requires that beneficiaries pay a monthly premium.
Part C provides: provisions for private health insurance. companies to provide benefits through managed care plans.
Part D: Signed into law in 2003, created to provide prescription drug benefits to Medicare beneficiaries and requires a monthly premium payment.
Government Funding
Funding coming from the government, to help run facilities.
Private Contract
Direct payments by individuals for health services an payments made by private insurance companies
Consists of three types of private financing:
Direct payments by individuals
Employer- based insurance
Direct- purchase insurance
Managed Care
A system of healthcare in which patients agree to visit only certain doctors and hospitals, and in which the cost of treatment is monitored by a managing company.
The Patient Protection and Affordable Act of 2010 (ACA)
Healthcare reform, that addresses three of the key policy areas including access to care, quality in terms of health outcomes, and constant in cost containment.
Funding for TR services
Tax base appropriations from the federal, state, or local government, grants and contracts, contributions and donations, fees, charges, and reimbursement, and a combination of any of the aforementioned sources.
Ancillary Services
Prescribed by a physician to meet a consumer need.
Routine Services
Provided as a part of basic services and are usually built into the overhead of operating costs.
Budgets used in TR
Revenue and Expense (Operating Budget)
Capital expenditure budget
Program Budget
Zero-based Budgeting
Flexible Budget
Revenue and Expense (Operating Budget)
delineates the day-to-day expenses and revenues for a year
Capital expenditure budget
Shows how the money budgeted for capital expenditures is to be allocated among competing projects in the future.
Includes things such as new equipment, maintenance of current buildings, and cost saving improvement.
Typically ranging from 3-5 years
Zero-based Budgeting
A budgeting approach in which managers begin with a budget of zero.
Program Budget
focused on meeting goals and objectives or allocating resources based on costs and benefits of specific programs.
2 types of program budgets:
Cost to charge ratio
Activity Based Costing
Flexible Budget
It is a budget that allows a manager to adjust a budget depending upon unexpected occurrences like a small number of patients or patients who are more severely injured and require different, perhaps more intense, interventions and previously budgeted.
