Future Directions Exam Flashcards
Interim Federal Health Program - what is it, and who is eligible?
offers basic healthcare services (similar to what is offered by social assistance)
eligible recipients: refugees, victims of human trafficking, detainees
Accord on Healthcare Renewal
- what
- when
- plan
10 year plan to strengthen healthcare
2003 after Romanow Report
reduce wait times, address HCP shortage, home care, primary care
Triple Aim
- improve the health of the population
- improve the patient experience
- lower (or hold constant) the per capita cost
Explicit Health Policy can Achieve (4)
- defines a vision = establishes targets
- outlines priorities and roles
- builds consensus
- informs people
Leichter’s Framework on Influences on Public Policy Change Process (4)
- situational - transient/impermanent conditions
- structural - unchanging elements (political system, economy, demographics)
- cultural - degree of trust, religious differences, ethnicity
- environmental - international/external factors
4 ways to analyze the issue during the policy process
- social/cultural analysis
- political analysis
- critical analysis
- economic analysis
6 defining characteristics of wicked problems
- cannot be defined until a solution is proposed
- no precise stopping point
- no right or wrong solutions
- unique and specific to context
- affects an infinite set of related problems
- resistant to policy solutions
Integrated Care from the eyes of the Patient (5)
- patient-centred care
- relational continuity
- informational continuity
- management continuity
- access
4 key characteristics of leaders
- trust
- stability
- compassion
- hope
Health as a right (5 factors)
- affordability
- accessibility
- availability
- accommodation
- acceptability
7 Health Care System Barriers
- Limited attachment to a health care provider
- unavailability of extended health care services
- complexity of the health care system
- geographic and operational barriers
- discontinuity and limited partnerships between health services and community services
- the broader social determinants of health
- lack of culturally-competent health services
3 Parts of a Quality Improvement Plan
- Progress Report
- Narrative
- Work Plan
6 Required Organizational Practices for Accreditation
- Safety Culture
- Communication
- Medication Use
- Work life/Workforce
- Infection Control
- Risk Assessment
Abida
The return to relationships - ensure every Canadian has regular access to a family doctor
Ahmed
A nation with a drug problem - prescription drugs under medicare
Sam
Don’t just do something, stand there - reduce unnecessary tests and interventions
Susan
Doing more with less - reorganize health care deliver to reduce wait times and improve quality
Leslie
Basic income for basic health - implement a basic income guarantee
Jonah
The anatomy of change - scale up successful innovations to a national level
What better care looks like (Martin in Susan’s story - 5)
- cut the cue
- broaden horizons
- use hospitals wisely
- get disruptive
- help people die with dignity
3 main roles of House of Commons
- represent the people of Canada
- pass laws
- protect our interests between elections
5 principles of medicare
- universality
- public administration
- portability
- accessibility
- comprehensiveness
Romanow Report (when and what)
2002 - concluded that primary healthcare most important thing moving forward
Pac Man Fallacy
Wrong belief that the growing cost of healthcare will always continue to grow at the same rate
“one big ministry of health”
Easton’s Framework - 4 inputs into a political system
- values - objects that have meaning to people
- demands - wishes of various groups that address their personal interests
- resources - means available by the government to meet demands
- support - public acceptance of these demands
Health Care Zombies (3)
- User-Fees
- Private Pay
- For-Profit Healthcare
4 stages in the policy cycle
- setting the policy agenda
2, moving into action/legislation - policy implementation
- policy evaluation
5 criteria for a policy issue to survive (Kingdon)
- technical feasibility
- value acceptability with policy community
- tolerable cost
- anticipated public acceptance
- elected official receptivity
3 Levels of Healthcare Vortex
Macro - Health and social policy
Meso - Health system
Micro - Personal Health
The 3 Ps of Human Trafficking
Prevention
Protection
Prosecution
8 Driving Forces of Change r/t Healthcare Reform
- spending growth
- perception of quality
- labour market
- comparators (to OCED average)
- accountability
- politicals/ideaology
- Health provider lobbies
- Industry
4 Change Priorities for Health Care Reform
- ECFAA
- Patients First: Action Plan for Health Care
- Canadian Foundation for Healthcare Improvement
- Southwest LHIN
4 Main Objectives of Patient First Ontario
- Access - provide faster access to the right care
- Connect - deliver better coordinated and integrated care in the community, closer to home
- Inform - provide the education, information and transparency needed to make decisions
- Protect our universal health care system - making evidence based decisions on value and quality
Legislated Priorities as Part of ECFAA (8)
- quality committees
- patient surveys
- employee surveys
- patient-relations process
- declaration of values
- QIPs
- Performance based compensation
- critical incident reporting
CNA 5 in 5 priorities
- increase % of after hours primary-care services
- increase chronic disease case management
- increase access to electronic health info
- decrease hospital admissions for uncontrolled diabetes
- decrease prevalence of childhood obesity
Family Practice Models (5)
Comprehensive Care Model Family Health Group Family Health Organization/Network Family Health Team Community Health Centre
2 types of failure
Failure to execute
Failure to innovate
3 dimensions of poverty (multidimensional poverty index)
- health
- education
- living standard
10 poverty indicators (multidimensional poverty index)
- nutrition
- child mortality
- years of schooling
- school attendance
- cooking fuel
- sanitation
- water
- electricity
- floor
- assets
4 ways to intervene in a patient’s poverty
- ask and listen
- prescribe an income
- have a poverty team
- demand change
Social Justice Guage for new policies/practices ask (CNA)
- acknowledge that groups occupy different positions of social advantage
- acknowledge inequities in opportunities, outcomes of groups
- acknowledge root causes of inequities
Emanciptatory Nurses Attuned To:
- conditions that shape health
- determinants of inequities
- distribution of power
A culture of safety according to Health Quality Ontario (6)
- safe
- effective
- patient-centred
- efficient
- timely
- equitable
PDSA
Plan
Do
Study
Act
Six-Sigma
Define Measure Analyze Improve Control
Designing Improvement (5)
- learn with it takes to make improvement
- amend interventions to adapt to context
- concepts are a goods tarting point for testing and learning
- provide a prediction on the degree of beleif that a model will have an impact in a particular setting
- improvement requires social change and people are likely to act if they believe
5 types of primary health care
- promotive
- preventative
- curative
- rehabilitative
- supportive/palliative
Principles of Primary Health Care
- accessability
- public participation
- health promotion
- appropriate technology
- intersectoral co-operation
PSW role 4 tasks
- activities of daily living
- clinical care services
- instrumental activities of daily living
- controlled acts
3 factors r/t RN RPN assignment
- the client
- the nurse
- the environment
4 models of nursing care
- total patient care
- task oriented
- team nursing
- primary nursing