Final Exam Flashcards
Which communication style:
- get excited
- ask “who”
- show emotion
- likes applause, feedback, recognition
- likes challenges and to get ahead
- relies on hunches and feelings and intuition
Expresser
What communication Style:
- they like their own way, decisive and strong viewpoints
- asks “what”
- takes charge
- results/goal-oriented
- competitive
- like to save time and be efficient
driver
What communication style:
- like positive attention, to be helpful and regarded warmly
- asks “why”
- dislikes rejection and being treated impersonally
- likes/values friendships, close relationships
relater
what communication style:
- seeks data, asks many questions, methodical and systematic
- asks “how”
- dislikes making errors and being unprepared/spontaneity
- likes activity and busyness
- makes decisions at own pace not cornered or pressured
analytic
what communication style:
- put the rights or others before own, minimizing own self-worth
passive
what communication style:
- stand up for your rights while maintaining and respecting rights of others
assertive
what communication style:
- stand up for rights but violate rights of others
aggressive
what is the role of communicaiton in pt outcomes? (6 things)
- improved pt satisfaction
- improved adherance to tx plans
- better clinical outcomes
- fewer medical errors
- fewer malpractice claims
- increase career longevity
what part of the brain does executive functions for cognitive empathy
pre-frontal cortex
what part of the brain has a role in memory that plays a role in perspective taking
temporal lobe
what part of the brain is responsible for emotional empathy
limbic system
what part of the brain has mirror neurons for reflexive empathy
pre-motor area
what are the 3 types of difficult conversations
- what happened
- feelings
- identity
which type of difficult conversation:
- seeks to understand more about circumstance
- dont argue, explore
- view from other perspectives
- be curious, not certain
- dont assume intentions
consider contributions instead of placing blame
what happened converstaion
what difficult conversation:
- emotions are the heart of conversation
- ignoring them makes the probelem worse
- negotiate emotions
- express dont evaluate
- acknowledgement of other emotions
feelings conversatoin
what difficult conversation:
- am I competent?
- am I a good person?
- am I worthy?
- become aware of your triggers
identity conversation
what are the 5 steps to a difficult conversation
- get started - think like a 3rd party, extend an invitation
- speak up
- learn - be an active listener
- ask questions
- begin to problem solve
what are the 3 types of feedback?
appreciation
coaching
evaluation
what type of feedback:
- to see, acknowledge, connect, motivate, thank
appreciation
what type of feedback:
- to help receiver expand knowledge, sharpen skill, improve capability
coaching
what type of feedback:
- to rate or rank against a set of standards, to align expectations, to inform decision making
evaluation
what is GRIT?
Growth
Resilience
Instinct
Tenacity
what type of feedback:
- “the hard work you put in to the evaluation was very evident”
appreciation
what type of feedback:
- “you measured the pt’s shoulder IR wrong”
evaluation
what type of feedback:
- you are right at the beginner level, which is where I expect you to be”
evaluation
what type of feedback:
- “your eval took too long, go faster next time”
coaching
what are 3 types of triggers
truth
relationship
identity
what type of trigger:
- related to feedback itself
- we feel it is wrong, unhelpful, unreasonable, etc.
can look like anger, defensiveness, dismissal
truth trigger
what type of trigger:
- related to the person giving the FB
- perception that they dont have credibility
- perceptions about intent or motive
- may result in hurt feelings, anger, suspicion
relationship trigger
what type of trigger:
- focus is the FB receiver
- brings up feelings of shame, doubt, unworthiness, etc
identity trigger
what are the 4 principles of ethics
- autonomy
- beneficence
- nonmalfecience
- justice
what ethic principal:
- acknowledge people’s right to make choices for themselves based on own values and beliefs
autonomy
what ethic principal:
- one ought to prevent and remove evil or harm, do good and promote good
beneficence
what ethic principal:
- do not inflict evil or harm
nonmaleficence
what ethic principle:
- treat others equally and fairly
justice
law, ethic or policy:
- it is illegal to drink and drive
law
law, ethic or policy:
- should not treat a pt when impaired from alcohol
ethic
law, ethic or policy:
- workplace is drug and alcohol free
policy
what are the 7 steps to solving an ethical problem?
- what is the problem and why
- what are the facts
- interested parties
- need further info?
- possible solutions
- action?
- future?
what are the 4 leadership approaches
trait
skills
behavior
adaptive
which leadership style:
- idealized influence (we look up to them)
- inspirational motivation
- intellectual stimulation (value big ideas)
- individualized consideration (work well individually with people on their team)
- lead rom the front
Transformational
which leadership style:
- power oriented
- self-consumed
- does not encourage independent thought
- little caring for others
- come across as charismatic but not really
pseudo transformational
which leadership style:
- contingent reward
- management by exception
transactional
which leadership style:
- revolves around power
- directs and controls all activities
- low follower autonomy
- demands obedience
- military
authoritarian
which leadership style:
- hands off approach
- non-transactional
laissez-faire
which leadership style:
- extremely self-aware
- leads from own core values
- strong sense of purpose
- builds relationship
- disciplined, focused
authentic
which leadership style:
- seeks to help, develop, guide followers
- sensitive to emotional well-being
- puts followers first
- strong moral/ethical code
servant
which leadership style:
- focuses on solving large/major problems
- teaches follower how to prepare and deal with change
- can see the big picture
- gives followers a voice
adaptive
why is documentation necessary? (6)
- record of patient mngmt
- communication
- demonstrate clinical problem solving and EBP
- legal record
- reimbursement
- outcomes
what is the role of documentation in legal considerations
- laws, regulations and policies
- informed consent
- malpractice and risk management
what are some ethical and legal considerations involving documentation
- pt safety and quality of care
- confidentiality
- fraud and abuse
for proper reimbursement, payors need to see that care is…
skilled
necessary
consistent with charges
effective
what are the 3 main payment systems
value based
prospective
fee for service
what type of payment system:
- payment based on outcomes
- also known as alternative payment model
value based
the value based payment system aims to … (4)
- reduce cost
- improve pt satisfaction
- improve quality of care
- improve health
what payment system:
- lump sum payments
- predetermined
- pt classification system - pt dx
- operating and capital expenses
prospective
what payment system:
- payment based on dollar amt ascribed to each service
- volume = greater reward
- quality of care does not matter
fee for service
what is the role of ICD-10 in its role in documentation and billing
- used for clinical and research purposes
- insurance providers
- public health sector
- consistency needed for reimbursement
ICD-10 codes can be _____ specific or ______ specific
diagnosis
sign/symptom
T/F - CPT codes are discipline specific
False
T/F - CPT codes for re-eval and eval are not timed codes
True
How is evaluation code determined?
complexity - High, Mod, Low
what do timed codes require?
direct, one-on-one pt care
for timed codes - treatment is provided in ___ min increments starting at ____ min
15 min
starting at 8 min
what are some examples of timed codes
ther ex
neuro re-education
gait training
MT
what are some examples of non-timed codes
hot/cold pack
mechanical traction
e stim
group therapy
T/F - untimed codes require direct, one-on-one pt care
False - do not require
how many units are billed for untimed treatments
1 unit
what is CCI?
correct coding initiative - says that some things cannot be billed for on the same day and if they are they require a modifier
what are the qualifications to receive Medicare
age > 65 yrs
younger than 65 yrs with a disability
end stage renal disease
what settings does Medicare Part A pay for?
acute care
IRF
SNF
HH
Hospice
what does medicare part B pay for
OP therapy
physician visits
DME
HH
what is the soft cap for PT, ST and OT in medicare
$2150 for PT and ST combined
$2150 for OT
what does Medicare Say about co-treatments
- must document medical necessity
- cannot be more than 2 disciplines treating at once
what does medicare part A say about co-treating
each therapist can bill for the entire time
what does medicare part B say about Co-treatment
cannot both bill for entire session
medicare and group therapy for acute care - Part A or B?
- allows treatment of more than 1 pt at a time
- need to use the term concurrent
- splits time and charge
part A
medicare group therapy IRF and SNF - part A or B?
- doing similar activities
- therapist must be in constant attendance
- 2-6 pts, restircted to 25% of total treatment time
part A
Medicare group therapy - Part A or B?
- if more than 1 pt is being seen at a time, must be billed as group therapy
- must be skilled care
- untimed
- similar level of function
- therapist must be in constant attendance
part B
medicare and students Hospital - part A or B?
- no problem with reimbursement or documentation
- can be general supervision
part A
Medicare and students SNF - Part A or B?
- no problem with reimbursement or documentation
- must be in line of sight supervision
Part A
medicare and students - Part A or B
- will not pay for services provided by unlicensed personnel
- doesnt mean students cannot be hands on
- APTA recommends students do not document directly in the chart
part B
what is a public health insurance program for low income adults, children, pregnant women, elderly adults and people with disabilities
medicaid
what does medicaid say about co-treatments
- must be prescribed by physician
- primary therapist must be designated
- only primary therapist can bill
- must be medically necessary
what does medicaid say about students
- considered auxiliary personnel
- may participate in PT services
- must be supervised
- may not bill for services provided solely by auxiliary personnel
what is a deductible
how much you have to pay out of pocket before insurance pays
what is a co-pay
how much you pay per appointment
what is co-insurance
% of total that you owe
Ex: if it is 20/80, you pay 20% and insurance pays 80%
what are 3 things that good discharge planning can help with
- reduce hospital readmission rates
- improve pt outcomes/recovery
- reduce burden on pt families
what are 3 things that can occur due to poor discharge planning?
- leads to excessive health care costs
- reduced medicare payments
- increased mortality rates
what does ALGEE stand for?
A - assess risk for suicide or harm
L - Listen nonjudgementally
G - give reassurance and info
E - encourage professional help
E - encourage self-help
what type of bias:
- feeling a connection to those similar to us
affinity bias
what type of bias:
- stereotypes and assumptions about diff groups
perception bias
what type of bias:
- projecting positive qualities onto people w/o actually knowing them
halo effect
what type of bias:
- looking to confirm our own opinions and pre-existing ideas
confirmation bias
who is the ally
the subject and the observer
integrated patterns of human behavior that includes language, thoughts, actions, etc.
culture
ability to establish relationship with persons of diff cultures
- requires understanding of others, willingness to embrace ideas, values, beliefs, etc. that are diff from own
cultural competency
a realization that learning about other cultures is a lifelong process while also realizing one may never be able to understand another culture fully
cultural humility
using cultural competence to learn about the pt and apply it to the delivery of care
cultural responsiveness
characterized by attitudes, policies, structures, and practices within a system or organization that are destructive to a cultural group
cultural destructiveness
lack of capacity of systems and organizations to respond effectively to the needs, interests, and preferences of culturally and linguistic diverse groups
cultural incapacity
expressed philosophy of viewing and treating all people as the same
cultural blindness
level of awareness w/in systems or organizations of their strengths and areas for growth to respond effectively to culturally and linguistically diverse populations
cultural pre-competence
what are the 4 steps to motivational interviewing
engaging
focusing
evoking
planning
