Exam 1 Part 1 Flashcards
The degree or grade of excellence of goods or services, including, in healthcare, meeting expectations for outcomes of care.
Quality
The continuous adaptation of a healthcare organizations functions and process to increase the likelihood of achieving the desired outcomes.
Performance Improvement
The first hospital in America, which became a model for the development of hospitals in other communities, was ___________ Hospital.
Pennsylvania
___________ General Hospital was the first hospital to practice the reporting of patient outcomes to the Hospital Board of Trustees. This hospital also set limitations on clinical practice in the first granting of clinical privileges.
Massachusetts
__________ was the first state to pass the nurse registration bill in the US.
North Carolina
In 1917, the American College of Surgeons (ACS) established the Hospital Standardization program, which marked the beginning of the accreditation process for healthcare organizations. The name of this program was ‘___________.’
The Minimum Standard.
In 1946, the __________ established funding to build new hospitals.
Hill-Burton Act
Conducted Chart audits and provided recommendations for improvement.
Peer Review Organizations (PRO)
Quality of Care and Improvement of Care
Quality assurance
Fee for Service
Retrospective Payment Systems
Fixed payment based on DRG
Prospective Payment Systems
Facility Resource Allocation Review
Utilization Review (UR)
Link Quality to Reimbursement
Also known as “Pay for Performance”
Value-based Purchasing
In the 1990s JCAH becomes _______ and Deming’s TQM philosophy begins to spread in US healthcare. _______ integrates quality improvement into the accreditation process.
JCAHO
In 2002, the Health Care Finance Administration (HCFA) becomes the ______________________
Center of Medicare and Medicaid Services (CMS)
In 2003, JCAHO implemented the ___________________ in the attempt to improve the quality of healthcare in the US.
National Patient Safety Goals (NPSG)
In 2009, ________ Legislation was passed which provided funding to health care providers to move towards technological integrations.
HITECH
In 2010, the ____________ Act passed which ensures equitable insurance coverage to all. (addressed issues such as pre-existing conditions, etc.)
Affordable Care Act
Changes in healthcare impacted providers which led to development of __________, a type of health insurance. Contract with health care providers and medical facilities to provide care for members at reduced costs.
Examples of health plans: PPO, HMO, and POS
Managed Care Plans
HMO stands for ________.
Health Maintenance Plan
PPO stands for _________.
Preferred Provider Plan
POS stands for __________.
This may include a hybrid of HMO and PPO
Point of Service
__________ were established by the Affordable Care Act of 2010 to assist Medicare beneficiaries for a period of at least 3 years. An ACO is a network of doctors and hospitals that share responsibility for providing care to patients. There are responsibilities to CMS that come along with this agreement.
Affordable Care Organizations (ACOs)
The evolution of Quality in Healthcare was sparked by ___________.
Edward Deming
The concept of _____________ engages the individuals directly involved in the work and they are the ones who make recommendations on improvement. TQM Concept: “Problematic processes NOT people cause inferior products and outcomes”
Total Quality Management (TQM)
In the 1990’s, quality improvement in healthcare was renamed _____________.
Performance improvement or PI
In 1999, the Institute of Medicine (IOM) published a landmark report titled __________. This report Raised the awareness of healthcare quality and patient safety in the US.
To Err is Human
In 2001, the IOM released a another new report titled _________.
Crossing the Quality Chasm
Crossing the Quality Chasm paper identified ___ core foundations that should be found in patient care.
Additionally, this paper also included 10 rules to redesign healthcare
6
Safe Effective Patient-centered Timely Efficient Equitable
6 core foundations that should be found in patient care
In 2002, Peer Review Organizations (PROs) were renamed ____________.
Quality Improvement Organizations (QIOs)
In 2014, the Improving __________________ Act was passed, which required reporting for LTACs, SNF, Rehab and Home Health agencies.
Medicare Post-Acute Care Transformation (IMPACT)
In 2015, the ________________ (MACRA) created the Quality Payment Program. Healthcare providers will no longer be paid for medical errors, complications and readmissions that resulted from lack of quality care.
Medicare Access and CHIP Reauthorization Act (MACRA)
Avedis Donabedian applied the concepts of TQM to healthcare by assessing four perspectives:
Structure
Process
Outcome
Cost
