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HLSC 152 > Exam #1 > Flashcards

Exam #1 Flashcards

1
Q

Health

A

A state of complete physical, metal, and social well-being and not merely the absence of disease or infirmity

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2
Q

“What Determines it?” -Health Status

A
  • Physical disabilities
  • Emotions
  • Social behaviors
  • Blood pressure
  • Ability to care for oneself
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3
Q

“What determine it?” -Population health

A
  • Birth rates
  • Life expectancy
  • Death rates
  • Commonality of disease
  • Group averages
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4
Q

Force Field Model of Health

A
  • Environment (Biggest effect)
  • Heredity
  • Lifestyles
  • Medical care/ Services (Smallest effect)
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5
Q

Disparities

A

Differences in health problems, health status, and use of health services among people who differ in ethnicity, gender, and other characteristics

-Can be explained using Force Field Model

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6
Q

Population health

A

Measuring a community’s health outcomes and factors that cause those outcomes, and then using those measures to coordinate the community’s people and organizations to improve health

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7
Q

Healthcare improvement “Triple Aim”

A
  • Improving patient experience
  • improving health of populations
  • reducing per capita cost of health care
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8
Q

Continuum of care

A

Full range of health care, beginning with prenatal care and continuing to end of life care.

  • preventative services
  • diagnostic services
  • treatment services
  • rehabilitative services
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9
Q

Environment of HCOs- HCO exists in an external environment of….

A
  • people
  • organizations
  • industries
  • trends
  • forces
  • events
  • developments
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10
Q

Environment of HCOs- HCO beyond healthcare includes…

A
  • citizens -schools
  • colleges -banks
  • computers companies -labor unions
  • stock markets -governments
  • research laboratories
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11
Q

Environment of HCOs

A

HCO exists in, and us influenced by a larger world

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12
Q

Environment beyond a single HCO

A
  1. Industry sector 6. Technology sector
  2. Raw materials sector 7. Economic conditions sector
  3. Human resources sector 8. Government sector
  4. Financial resources sector 9. Sociocultural sector
  5. Market sector 10. International sector
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13
Q

Clinical Performance-definition

A

The degree to which clinical professionals and healthcare organizations provide care that meets or exceeds the Institute of Medicine’s (IOM) aims

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14
Q

Clinical performance

A

The execution of an action, something accomplished, the manner in which a mechanism performs

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15
Q

Six domains of Health Care Quality

A
  1. Safe- avoiding harm to patients
  2. Effective- Providing services to benefit
  3. Patient centered- Patients needs, values, and preference
  4. Timely- Smaller waits/ harmful delays
  5. Efficient- Avoid waste of; equipment, supplies, ideas, energy
  6. Equitable- Provide care to all, not being bias
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16
Q

Ensuring Accurate Diagnosis

A
  • Determining the nature of the disease
  • Process is “heuristic” (iterative, trial and error) throughout
  • “differential diagnosis” is key to manage uncertainty
  • Process of elimination such as symptoms, patient history, and medical knowledge
  • Involves CSS
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17
Q

Patient management protocols

A

Formally established expectations that define the normal steps or processes in the care of a clinically related group of patients at a specific institution

18
Q

Functional protocols

A
  • Procedures and set of activities to carry out elements of care
  • How procedures are carries out (how to give an injection)
19
Q

Physicians Credentialing & Delineating Privileges- Credentialing

A
  • Verified physician meets standards

- Licensing, experiences, certifications, education, training, etc.

20
Q

Physicians Credentialing &Delineating Privileges- Privileging

A
  • Defines physicians scope of practices and clinical services she or he may provide
  • Based on credentialing and is data driven process
21
Q

Physicians Credentialing & Delineating Privileges- Contract with 4 elements

A
  • Bylaws
  • Privileges extended for one or two years based on peer review- attending physician
  • Independent physician- patient relationship
  • Continuous improvement and peer review
22
Q

HCO Managers “Hot spot”

A

HCO managers are committed to the organization and community, while balancing individual needs with that of the good of the whole

23
Q

Physicians “Hot spot”

A

Physicians act like agencies, committed to patients and ethnically committed to patients above all else

24
Q

HCO managing conflict

A

HCOs listen attentively to the needs and concerns of their physician, involving them in decision making, make an effort to understand the language of medicine and their physicians, and that they are valued

25
Q

Significance of Nurses

A
  • outnumber physicians 4 to 1
  • Most seen member of CSS by patients and families
  • Medium-sized HCO employs 400 nurses
  • Largest clinical profession
  • National shortage
  • Turnover 50% in bad HCO- costly
  • Spend 31-44% of time in direct patient care
26
Q

Managerial Issues

A
  • Keep nursing work attractive

- Improve nurses effectiveness

27
Q

Nursing performance measures

A
  • Demand -Outcome quality
  • Costs -Process quality
  • Human resources -Patient satisfaction
  • Output/productivity -Physician satisfaction
28
Q

Charge Nurse

A

Assumes responsibility for the day to day operations of patient care

29
Q

Clinical Support Services- What is it?

A
  • Most seriously ill patients require support beyond those of physicians and nurses
  • Work independently of primary giver teams (physicians & nurses)
30
Q

Clinical Support Services- Purpose of CSS?

A

-CSS are core contributions to any HCO

31
Q

Clinical Support Services- Purpose of HCO in assisting CSS?

A

To ensure “seamless” coordination of high quality care, HCO

  • create environment where CSS professional want to work
  • interstate CSS into its overall operation
  • support CSS to provide excellent services
32
Q

CSS in large HCO (exhibit 8.1)

A

=Diagnostic services

  • Audiology
  • Cardiopulmonary
  • Clinical laboratory
  • Consultive services
  • Diagnostic imaging
  • Electroencephalography
  • Electromyograph

=Therapeutic services

  • Anesthesia
  • Blood bank
  • Nursing
  • Optometry
  • Orthotics
  • Palliative care
  • Pharmacy
  • Radiation therapy
  • Rehabilitation

=Social and Counciling services

33
Q

Historical Perspectives

A

Hospitals in the early America were funded to shelter older adults, the dying, orphans, vagrant to protect from community from becoming sick

34
Q

Sources that shaped the Hospital Industry

A
  • growth in private hospital insurances
  • medical advances
  • medical specialization
  • Medicare and Medicaid
  • # of hospitals in US increased 178-4,300
35
Q

Financial conditions in hospital 1990-2000s

A
  • Hospital economic probs, combo of factors

- Balanced Budget Act 1997- reduced payments for Medicare patients

36
Q

Complexity of system- Hospitlas

A
  • 3/4 US hospitals employ more than 1,000 workers; contract workers, large campus
  • maze of communication challenges
  • different kinds of employees, complex diagnostic
37
Q

Types and roles of patients

A

Patients in hospitals, removed from usual social environment, were in a dependent relationship with authority

-“Submissive sick” role
-Hospital works its own schedule
Physicians spend so little time with patients

38
Q

Diagnosis related group hospital reimbursement system

A

1st-

  • Hospital physicians decided when patients can go home
  • started to cost to much for hospitals
  • hospitals were paid a set amount for each day that patient stayed in the facility
  • hospitals took advantage and drained out medicare
  • Big burden

2nd-

  • Hospital stays were becoming to long for patients
  • dangerous for patients due to exposure to infectious disease
  • could bring infection home
  • shorter stays the better
39
Q

Quality of Hospital care hazards

A

IOM finding 1997: 44,000 to 98,000 deaths annually due to med errors
-more than motor vehicle accidents

40
Q

Innovation: Hospitalists

A
  • ACA radically alter virtually all dimensions of hospitals
  • Four elements
    1. Population focus
    2. Market consolidations through mergers and acquisitions
    3. Accountable care organizations (ACOs)
    4. Reimbursement and payment revisions

HLSC 152 (3 decks)

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