Concepts and Trends in Healthcare Flashcards
Health
a state of complete physical, mental, and social well being and not merely the absence of disease or infirmity.
Holism
viewing a person’s health as a balance of body, mind, and spirit
Wellness
a state of being; a constant and intentional effort to stay healthy and achieve the highest potential for total well being
Illness
a state of being sick
Disease
a pathological condition of the body that presents with clinical signs and symptoms and changes in laboratory values
Health Maintenance
protecting one’s current level of health by preventing illness or deterioration
Health Promotion
engaging in strategies to enhance health
Illness Prevention
identifying and reducing the effects of risk factors on one’s health
Early Detection
uses screening diagnostic tests and procedures to identify a disease process earlier
Client
active partner in nursing care, the person receiving healthcare services.
Healthcare Team
specially trained personal who work together to help clients meet their healthcare needs
Healthcare Delivery System
the full range of services available to people seeking prevention, identification, treatment, or rehabilitation of health problems.
Primary Care
initial contact often w/ family practitioner, internist, or nurse practitioner; emphasis is on health promotion, preventive care, health education, early detection, and treatment.
Secondary Care
referrals to facilities for additional testing such as cardiac catheterization, consultation, and diagnosis as well as emergency and acute care interventions.
Tertiary Care
focuses more on complex medical and surgical interventions, cancer care, rehabilitative services, long term care, and palliative and hospice care.
Health Care Reform (Obama Care)
(Patient Protection and Affordable Care Act- PPACA) passed in 2010; designed to provide affordable healthcare to U.S citizens who previously had no access to health insurance.
Medicare
a federally run program financed primarily through employee payroll taxes; it covers individuals who are 65 or older, permanently disabled workers, and persons with end stage renal disease
Medicaid
federally funded, state program that provides medical assistance for individuals with families with limited income and resources.
Prospective Payment System (PPS)
method of reimbursement in which healthcare providers receive payment for services based on a predetermined, fixed rate
Managed Care Organizations (MCOs)
insurers who carefully plan and closely supervise the distribution of healthcare services
Preferred Provider Organization (PPO)
create a community network of providers who are willing to discount their fees for services in exchange for a steady stream of referred customers
Physician Hospital Organization (PHO)
creates a corporate structure between hospitals and groups of physicians—they contract with an MCO to negotiate fees for services for self insured employees
Point-of-Service (POS)
clients select a primary care physician within the group who then serves as the gatekeeper for other healthcare services
Integrated Delivery System (IDSs)
provide a full range of healthcare services with a goal of achieving highly coordinated and cost effective care.
Clinical Pathways
care mapping for specific diagnoses and procedures which standardize important aspects of care
Quality Improvement Committees
use standardized indicators to measure healthcare quality
Prevention QIs
identify hospital admissions that could be avoided through high quality out patient care
Inpatient QIs
reflect quality of care inside hospitals, including inpatient mortality for medical conditions and surgical procedures
Patient Safety QIs
reflect quality of care within hospitals but focus on potentially avoidable complications and adverse events
Pediatric QIs
reflect quality of care inside hospitals and identify potentially avoidable hospitalizations among children
Healthy People 2020
campaign that provides an overall action plan to improve the health and quality of life for people living in the united states
