Concept Identification Exercise Flashcards
Emma, a 5-year-old with profound hearing loss, is approved for a cochlear implant surgery. However, the only qualified surgical center is located several hours from her rural hometown. The long travel distance, combined with multiple pre-operative, surgical, and post-operative appointments for mapping and therapy, creates a significant burden for her family.
access issue
Due to budget constraints, the hospital maintains a high patient-to-nurse ratio, particularly during night shifts
quality of care - structure issue
nurses and staff are considered: structure,
A patient with hearing loss and vestibular issues is referred to both an audiologist and a physical therapist. Due to poor communication between providers, the patient receives conflicting advice and incomplete treatment plans
quality of care - problem with the process
Miguel, a part-time delivery driver, starts having trouble hearing conversations on the phone. When he visits an audiologist, he learns he needs hearing aids costing several thousand dollars. His insurance doesn’t cover the expense, and he cannot afford the upfront payment.
cost - limits his access
financial access issue
Assessing the probability of an adverse health occurrence and the severity of consequences.
risk management - steps in management of risk (identifying the risk, analyzing, etc.)
Hospitals implement standardized protocols to ensure patients are correctly identified before administering treatments or medications. This typically involves using at least two patient identifiers, such as name and date of birth, and cross-referencing them with medical records and wristbands.
risk management - system has to be reliable
related to reliability
A patient with comprehensive health insurance regularly visits the emergency room for minor ailments, such as a sore throat or mild stomach pain, rather than scheduling an appointment with a primary care provider.
moral hazard
Prescribing antibiotics for viral infections, where they are ineffective.
overuse
Due to insufficient verification procedures during the fitting process, hearing aids are programmed with incorrect gain levels. One patient experiences persistent discomfort and poor speech clarity in noisy environments.
quality issue - (don 3 constructs - structure, process, & outcome)
process concern - care is not delivered correctly
Zara, a recent immigrant from India, visits an audiology clinic because her 6-year-old son struggles to hear in school. The audiologist provides instructions in English, using medical terminology that Zara finds difficult to follow.
access issue - cultural competence of care
A hospital continues using older diagnostic imaging equipment to avoid the costs of purchasing newer models. As a result, the radiology department frequently encounters technical malfunctions and lower image resolution.
quality issue - structure issue
Carlos, a 34-year-old warehouse worker, is recommended for bilateral cochlear implants after sudden hearing loss. Although his insurance covers part of the surgery, the out-of-pocket expenses for device maintenance, speech therapy, and post-implant programming sessions are beyond his financial reach.
cost - financial access
Conducting comprehensive audiometric evaluations, such as advanced auditory brainstem response (ABR) tests or extensive vestibular assessments, without clear clinical indications.
overuse
Due to time constraints, an audiologist provides minimal counseling on hearing aid use and maintenance. A patient is sent home with a new pair of hearing aids but receives only a five-minute overview on device insertion and care. Within days, the patient experiences difficulties and stops using the devices.
quality process iissue
Hospitals assess patients’ fall risks upon admission and implement tailored interventions, such as bed alarms, non-slip footwear, and assistance with mobility. Regular staff training and environmental modifications, like adequate lighting and clear pathways, further support fall prevention efforts.
patient risk
controlling this is doing what - reliability (trying to prevent falls)
Conducting routine cancer screenings, such as prostate-specific antigen (PSA) tests in men over a certain age or mammograms in elderly women with limited life expectancy
overuse
A patient with early signs of progressive hearing loss is misdiagnosed with stable mild hearing loss due to incomplete audiometric testing. Without timely intervention, the patient’s hearing deteriorates significantly before returning for a follow-up.
process issue
The clinic lacks proper cleaning protocols and sufficient hand sanitizing stations. Shared equipment, such as otoscopes and hearing aid programming devices, is not consistently sanitized between patients.
structure & process issue
Not conducting routine screenings for conditions like colorectal cancer or hypertension may delay early detection and treatment.
underuse
Martha, a senior living in a rural area, is offered a telehealth appointment for her hearing assessment. However, she lacks reliable internet and struggles to use video conferencing technology.
access issue
Isaiah, a college student, reports persistent tinnitus to his audiologist. His primary care provider dismisses his concerns, suggesting that young people don’t need audiological treatment and that Isaiah is likely overreacting.
lyn, a 72-year-old retiree, undergoes a successful cochlear implant procedure but struggles with post-surgery virtual programming sessions offered by the audiology clinic. She lacks familiarity with video conferencing tools and internet access at home. Without access to in-person support, Evelyn is unable to have her implant properly mapped, leading to limited improvement in her hearing ability.
An audiology clinic continues to use aging audiometers and hearing aid verification systems due to budget constraints.
structural & quality
Andre is 13 years old and lives with his mother. She struggles financially as a single mom. He has profound hearing loss and is recommended for a cochlear implant. During counseling, the healthcare team assumes his family will not be able to afford or adhere to the follow-up care due to socioeconomic stereotypes. As a result, they present only limited options instead of the comprehensive plan that would best serve Andre’s needs.
moral hazard
A patient with generous insurance coverage undergoes multiple MRI scans and blood tests for minor back pain.
overuse caused by moral hazard
A woman living in a rural community has to drive over two hours to the nearest hospital for specialized care
access issue
A hospital aiming to cut operational costs reduces its nursing staff by 15%.
quality - structure issue
Patients with tinnitus receive generic counseling without tailored sound therapy or management plans. As a result, one patient continues to experience severe distress and sleep disturbances.
quality - process
To control pharmaceutical expenses, a health insurance provider mandates the use of generic medications over brand-name drugs.
did this due to cost,
quality issue - this may lead to those not
Encouraging staff to report adverse events, near misses, and unsafe conditions.
identifying risk
Not prescribing statins to patients with high cholesterol and elevated cardiovascular risk can lead to preventable heart attacks and strokes.
underuse - not oing something we know would help
A young freelancer experiences severe dental pain but postpones treatment because his insurance doesn’t cover dental care
financial access
A healthcare system transitions to telehealth appointments as a cost-saving strategy, reducing the need for physical clinics.
increasing and decreasing access - causing issues with quality of treatment
A hospital’s emergency department lacks a well-designed triage area, resulting in overcrowding and inefficient patient flow.
structural quality issue
An audiology clinic reduces appointment times to accommodate more patients per day and lower operational costs.
increases pay you receive but results in les stime with patients so quality of care
hospital’s surgical department experiences a high rate of infections following orthopedic procedures.
outcomes
To prevent pressure ulcers, hospitals conduct regular skin assessments, employ pressure-relieving devices, and schedule patient repositioning. Staff education on early detection and intervention plays a crucial role in maintaining skin integrity.
risk management - improving reliability
A recent immigrant struggles to explain her symptoms at a clinic because there are no interpreters available
access - cultural competence
Audiologists at a clinic use different protocols for hearing assessments, leading to variability in test results.
quality - (4 issues: underuse, overuse, misuse, variation in use)
this one is variation in use
A patient on a prescription drug plan that covers most out-of-pocket expenses frequently requests name-brand medications
moral hazard
An outpatient audiology center adopts a policy of charging patients for follow-up visits within six months of hearing aid fittings to reduce operational expenses.
access issue
quality issue - poor outcomes if they dont come
Due to a shortage of specialists, patients at a rural hospital must wait weeks or travel long distances for consultations with cardiologists, neurologists, and other specialists.
structure
PT it is an issue of access
To reduce procurement expenses, a clinic negotiates exclusive contracts with a low-cost hearing aid manufacturer.
saves the clinic money
for patients it leads to lower end tech, quality issues (if they need more advnaced we dont have it)
An elderly man requires a diagnostic test for a potentially serious condition but is told the next available appointment is three months away
access related to structural quality issue
A patient in the intensive care unit receives an incorrect dosage of a high-risk medication due to a transcription error in the electronic health record (EHR).
A female patient with chest pain is dismissed by a healthcare provider who assumes the symptoms are stress-related rather than taking immediate steps to rule out cardiac issues
quality - access issue
access, underuse
Eric, a self-employed graphic designer, notices a persistent lump on his neck. He has a health insurance plan with a high deductible and limited specialist coverage. Worried about the costs, he decides to wait.
financial access
A patient with a top-tier health insurance plan insists on surgery for a knee injury, despite the physician’s recommendation for physical therapy as the first course of treatment.
Nour, a Syrian refugee, visits an urban health clinic for recurring migraines. She doesn’t speak English fluently, and the clinic lacks interpreters familiar with her dialect. The physician assumes her headaches are due to stress and prescribes over-the-counter medication without conducting a thorough examination.
To lower costs, a clinic moves to virtual appointments for hearing aid programming and counseling.
James, a retired factory worker, experiences worsening chest pains. His primary care doctor refers him for a stress test at a nearby hospital, but the earliest available appointment is three months away.
A patient admitted with vague abdominal symptoms experiences diagnostic delays due to poor communication between departments and long waits for imaging. By the time the condition is identified as advanced-stage cancer, treatment options are limited.
Evelyn, a 72-year-old retiree, develops a painful skin condition. Since the local clinic now prioritizes virtual appointments, Evelyn struggles to navigate the online system to schedule a consultation. Without reliable internet access or technical skills, she tries calling the clinic but faces long hold times. Frustrated, she gives up.
A regional health system cuts funding for routine cancer screening programs to lower operational expenses.
An insurance company restricts its provider network to control costs, offering only a limited number of in-network specialists
A clinic’s intake process fails to capture essential information about patients’ hearing history, communication preferences, and previous hearing aid use.
hospital adopts bundled payments for joint replacement surgeries, incentivizing providers to stay within budget limits.
A state health department faces budget cuts and decides to limit newborn hearing screening to “high-risk” infants only, such as those with a family history of hearing loss or premature birth.
The hospital lacks an adequate number of negative-pressure rooms for isolating patients with airborne infectious diseases.
An insurance provider reduces its audiology network to cut costs, offering limited outpatient clinics for hearing care.
A hospital experiences maternal deaths due to preventable conditions such as postpartum hemorrhage and preeclampsia. Contributing factors include delayed responses and inadequate staff training on emergency obstetric care.
