Chapter 9 Flashcards
1
Q
How can managers help employees deal with work stress?
A
- encourage coworker support
- arrange flexible work schedules
- reward positive efforts to provide quality care
- encourage high levels of control over their work
2
Q
What are the sources of work stress?
A
- heavy workloads
- inter professional conflicts
- scarce resources
- understaffing
- physical strain
- emotional labor
- work/home conflicts
- limited input into decision-making
3
Q
What is utilization management?
A
- process that third-party payers use to manage their costs and quality of care that they are paying for.
- this is to determine whether patient care is efficient, effective, medically necessary, and appropriate as compared to the individuals needs and needs of previous patients with similar conditions.
4
Q
What are the 5 types of utilization reviews?
A
- precertification reviews
- admission reviews
- continued (concurrent) stay reviews
- discharge planning reviews
- retrospective reviews
5
Q
What is case management?
A
- a cost-control process of hospitals, insurance companies, and employers (primarily with high-cost medical conditions).
- a collaborative process of assessment, planning, facilitation, and advocacy to meet a patients needs through available resources to achieve cost effective outcomes.
6
Q
What are the 6 dimensions of patient care?
A
- safe (in healthcare facility and home)
- effective (evidence based)
- efficient (cost effective)
- timely (no waits/delays)
- patient-centered (preferences, put pt in control)
- equitable
7
Q
What are classified as quality defects?
A
- underuse (provide less than needed)
- overuse (using interventions/diagnostic when not indicated)
- misuse (not executing proper clinical care process)
8
Q
What are the two key aspects to patient satisfaction?
A
- content quality
- quality of the service delivered
9
Q
What are the 7 patient rights?
A
- to be treated with respect
- to make treatment choice
- to refuse treatment
- to obtain medical records
- to privacy of medical records
- to informed consent
- to make decisions about end-of-life care
10
Q
What are the 5 responsibilities of patients?
A
- be respectful to providers
- be honest with providers
- comply with treatment plans
- meet financial obligations
- report fraud and waste
11
Q
What does HIPAA stand for?
A
- health insurance portability and accountability act of 1996
12
Q
What is HIPAA good for?
A
- protects the privacy of patients medical records when shared among providers and insurers.
