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CDE Exam > CCM and Organization Of Care > Flashcards

CCM and Organization Of Care Flashcards

1
Q

What are the 2 main pieces of the CCM?

A

Organizational Approach

Quality Improvement Strategy.

**must be evidence based

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2
Q

Chronic care model being incorporated into professional practice is an important predictor of what?

A

10 year risk of CHD

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3
Q

Diabetes care must: 3

A

Be proactive

Be organized around the patient. Ie: patient supported in self management by inter professional team

Incorporate CCM

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4
Q

What are the six elements of the CCM that improve care?

DDSCCH

A

Delivery system design

Decision support ie clinical decision support system

Self management support

Clinical info system. Eg. EMR, patient registries

Community eg. Food. Housing security. Ability to lead active lifestyle, access to care, social supports

Health systems Eg. Incentive billing codes. Pay for performance Health promotion.

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5
Q

What are the 5 Rs of the organization of care?

A 
Recognize 
Register
Resource inter professional and self management
Relay-info sharing 
Recall.
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6
Q

Using the CCM for diabetes improves what parameters? Five

A

The CCM improves:

  1. A1C
  2. LDL-C
  3. Use of statins
  4. Drug and hospital expenditures
  5. Overall mortality
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7
Q 
Would a patient care flow sheet be an example of: 
Delivery system design 
Decision support 
Self management support
Clinical info
Community 
Health systems
A

Decision support

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8
Q 
Would a Disease management model that uses patient education, coaching, treatment adjustment, monitoring, care co-ordination be an example of: 
Delivery system design 
Decision support 
Self management support
Clinical info
Community 
Health systems
A

Delivery system design

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9
Q 
Would a peer-led self-management support groups be an example of: 
Delivery system design 
Decision support 
Self management support
Clinical info
Community 
Health systems
A

Community

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10
Q

•Promoting preventative care and appropriately planning resource allocation

 An example of: 
Delivery system design 
Decision support 
Self management support
Clinical info
Community 
Health systems
A

Health systems

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11
Q 
provider incentives for achieving milestones
 Is an example of: 
Delivery system design 
Decision support 
Self management support
Clinical info
Community 
Health systems
A

Health systems

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12
Q

Measuring units of insulin Cognitive
Psychomotor
Affective

A

Psychomotor

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13
Q

State willingness to take insulin.
Cognitive
Psychomotor
Affective

A

Affective

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14
Q

Describe action of insulin
Cognitive
Psychomotor
Affective

A

Cognitive

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15
Q

Being in the preparation stage means a person is ready to act in the next _____ days

A

30

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16
Q

Being in the contemplation stage means the person is ready to act in how long?

A

Within 6 months as the pros outweigh the cons for change

17
Q

Motivational interviewing includes what four general principles?
Hint: EE. DD. RR. SD

A

Expressing Empathy
Developing Discrepancy
Rolling with Resistance
Supporting Self efficacy

18
Q

If a patient says “ Diabetes is not so bad..” What stage of change are they in?

A

Pre-Contemplation.

19
Q

If a patient says “ So I’m

Overweight. If I dieted I’d probably die of a heart attack…” What stage of change are they in?

A

Pre-contemplation

20
Q

If a patient says “ if you just leave me alone maybe I would change!” What stage of change are they in?

A

Pre contemplative

21
Q

What stages of the transtheoretical model of change is motivational interviewing MOST helpful?

A

In pre contemplation and contemplation.
Pts need to process the pros and cons of change many times before moving from pre to contemplation. They must resolve ambivalence associated with not being ready to change!

22
Q

Telehealth is most successful

In resucing A1C when what

A

It allows for adjustment of medications.

23
Q

Which individuals with diabetes should work with an inter professional team with specialized training?

A

Chikdren with D
Adolescents and emerging adults with type 1 transitiining to adult care
Type 1
Women with diabetes who want to conceive or those with GD

24
Q

Which individulas MAY be considered for referral to a team with specialized training?

A

Type 2 who consiatently not meeting cardiometabolic targets.

Those with depression + D

25
Q

What is the difference between self management education (SME) and self management support (SMS)

A

SME. Systematic intervention involving active participation of the indiv in self monitoring and decision making with applying of skills and knowledge.
SMS -activities that support the implementing and maintenance of behaviours for ongoinf management . Includes education, behaviour modification, psychosocial and clinical support
Need BOTH!!!

CDE Exam (32 decks)

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