CH: The Health Care Delivery System Flashcards
Hospitals receive a set dollar amount based on an assigned group
Diagnosis-related groups (DRGs)
Eliminated cost-based reimbursement
Prospective payment system (PPS)
Providers receive a fixed amount per patient
Capitation
Used in long-term care
Resource utilization groups (RUGs)
Administrative control over primary health care services for a defined patient population
Managed care
Explain what integrated delivery networks (IDNs) are.
IDNs include a set providers and services organized to deliver a continuum of care to a population of patients at a capitated cost in a particular setting
Explain the difference between health promotion and preventative care.
- health promotion programs lower the overall costs of health care, reducing the incidence of disease, minimizing complications, and reducing the need to use more expensive health care resources
- preventative care is more disease oriented and focused on reducing and controlling risks factors for disease through activities
More services are available on nursing units, thus minimizing the need to transfer patients across multiple areas because of?
Work redesign
A centralized, coordinated, multidisciplinary process that ensures that the patient has a plan for continuing care after leaving the health care agency
Discharge planning
Identify the instructions needed before patients leave health care facilities.
- safe and effective use of medications
- instruction and counseling on food-drug interactions, nutrition, and modified diets
- rehabilitation techniques
- access to appropriate community resources
- when and how to obtain further treatment
- the responsibilities of the patient and the families with ongoing health care needs
The goal of restorative care is?
To help individuals regain maximal functional status and to enhance quality of life through promotion of independence and self-care
Give some examples of home care services.
- monitoring of vital signs
- administration of parenteral or enteral nutrition and medications
- IV or blood therapy
- wound care
- respiratory care
Restores a person to the fullest physical, mental, social,vocational, and economic potential possible
Rehabilitation
At skilled nursing facilities, patients receive
Extensive supportive care until they are able to move back into the community or into a residential care facility
The philosophy of care of a nursing center is?
To provide a planned, systematic, and interdisciplinary approach to nursing cars to help residents reach and maintain their highest level of function
Long-term care setting with greater resident autonomy
Assisted living
Provides short-term relief to the family members who care for the patient
Respite care
Allows patients to retain more independence by living at home
Adult day care center
Focus of care is palliative, mot curative, treatment
Hospice
What is the basic focus of community-based nursing?
Meeting the health needs of the population
True or False.
A community-based nursing center is an example of a traditional community-based nursing care setting
False. It is a newer form of community-based nursing care
True or False.
Goal setting is a key element of discharge planning for the client.
True
What is evidence-based practice?
A problem-solving approach to clinical practice that involves the conscientious use of best evidence along with clinical expertise and patient preferences and values in making decisions about patient care
What is the goal for pay for performance programs?
To reward excellence through financial incentives to motivate change to achieve measurable improvements
Uses information and technology to communicate, manage knowledge, mitigate error, and support decision-making
Nursing informatics
Focuses on improved health outcomes for an entire population
Primary health care
- prenatal and well-baby care
- nutrition counseling
- family planning
- exercise classes
Primary care
- emergency care
- acut medical-surgical care
Secondary Acute care
Explain nurse sensitive outcomes.
Patient outcomes and select nursing workforce characteristics that are directly related to nursing.
Health promotions programs are designed to help patients?
Reduce incidence of disease, minimize complications, and reduce the need to use more expensive health care resources
Rehabilitation services begin?
Initially focuses on the prevention of complications relayed to illness or injury. After the condition stabilizes, rehabilitation helps to maximize the patients level of independence
