DPT 5010 Test 2: "Other" Flashcards
Primary Sources of Law
I. Federal and State Constitutions
II. Legislatively Created Statutory Laws
III. Common (court case) Laws
IV. Administrative Law
(MN Board of PT, Dept. of Health)
Government operated
Secondary Sources of Law
I. Professional Association
(APTA)
II. Accreditation standards and guidelines
(JCAHO, CARF, NCQA)
III. Facility/Corporate Policies and Procedures
even if we are not an APTA member, they are Secondary Law, so their rules apply
Civil Action vs. Criminal Action
Civil: violate duty owed to an individual and/or his property
Criminal: violated duty owed to society as a whole
Doctrines of Law Common in PT
- Informed Consent
- False Imprisonement
- Abandonment
- Assault and Battery
- Mandated Reporter Rquirements
- Delegation of Duties (PTA; PT Aide)
Informed Consent
ethical and legal duty of every health care clinician to obtain patient (or surrogate) informed consent.
- Patient Autonomy
- Patient self-determination
Required Elements of Informed Consent
- explain diagnosis and pertinent findings
- nature of treatment intervention
- material risks of serious harm or complications
- expected benefits of treatment
- reasonable alternatives to proposed treatment
Must have informed consent 2x’s:
Exam & Treatment
False Imprisonment
Intentional
To unlawfully restrict a patient’s free movement.
- must have specific intent
- patient must be conscious of fact that he/she is being confined or threatened w/ force if he/she moves
Abandonment
Improper, unilateral termination of a patient by a treating physical therapist.
Where there is a professional-patient relationship
This termination must have caused injury to patient.
These injuries must warrant award of monetary damages in order to “make patient whole”
Assault and Battery
unjustified & unexcused
harmful, offensive or otherwise impermissible
intentional conduct by a tortfeasor
with another person
-can be direct or indirect acts of touching that offends patient
- impenidng contact –> make pt anticipate
must have informed consent to avoid this
self defense okay, but must be reasonable
Mandated Reporter
Must report:
Maltreatment
- abuse (physical or emotional)
Neglect
Exploitation
- Physical
- Emotional
- Financial
Template for Documenting a PT Plan of Care in Patient/Cline Management
Goals & anticipated outcomes
Proposed intervention
Anticipated frequency/duration for episode of care
Anticipated discharge plan
Goal
must include 6 components
made in collaboration w/ pt
must support medical necessity for PT services
must support need for skilled intervention
Proposed Intervention
should provide clear common. for coordination of care w/ staff
include:
- progression parameters
- precautions
- sequencing of interventions
- skilled monitoring required (vital signs, pulse ox, pain waiting, rate of perceived exertion, etc.
Anticipated Discharge Plan
“Transition Plan”
may be reflected in veal statement, goals, or written separate
American Heath Care Systems: What determines how we practice?
1. Legislation (Health care bills, State Practice Acts) 2. Reimbursement (Medicare/Medical Assistance, Private Ins. Payers, Managed care payers) 3. Regulatory Agencies 4. Accrediting bodies 5. Professional Organizations 6. Consumers
American Heath Care Systems: Financing vs. Delivery
Financing- payment for services including premium & payment
Delivery- provision of services
American Heath Care Systems: Models of Health Care Financing in U.S.
- Out of pocket payment
- Individual private insurance
- Employment based group insurance
- Government Insurance- Medicare, MA, VA
History of U.S. Health Care
1900-1940’s: Pts paid directly, provider decided cost
1940’s: Companies offer HC coverage for employees
1950’s: Advances in HC
1960’s: HC financed by private ins. companies and gov’t
1970’s: fee for service/ retrospective system
1980’s: Cost increase
1990’s Managed care expands to falter
2000’s: Increased freedom of choice for consumers and increased cost.
2010: Patient Protection & Affordable Care Act
Impacts of HC change on PT
dx related groups in hospitals (DRGs) common procedural terminology (CPT) managed care Balanced Budget Act of 1997 Therapy Cap Prospective Payment System (PPS) -skilled nursing facilities direct access
DRG’s
Diagnostically Related Groups
-provide guidelines to determine hospital reimbursement
CPT
Common procedural Terminology
-CPT codes for reimbursement –> payment determined by resource value
Managed Care
Health care payer and delivery system
Limit financial risk by purchasing healthcare services @ fixed rates.
*missing focus on quality
Balanced Budget Act of 1997
Reduction in Medicare and Medicaid spending a
Address fraud and abuse in Health Care spending
Direct Access to PT
Degree of direct access determined by state
MN APTA advocates for direct access
Vision 2020 for DPT education
- Autonomous Practice
- Direct, unrestricted access
- Ability to refer to other HC providers
- Diagnostic Tests
- Transition from MPT–>DPT
