Health Care Delivery Systems Flashcards
Prehistoric medicine and ancient medicine were characterized by an interest in the arts and sciences.
false - prehistoric and ancient medicine were both characterized by the belief that illness was caused by the supernatural, an attempt to explain changes in body functions that were not understood
The American College of Surgeons (AS) improved the quality of care for surgical patients by establishing standards for surgical education and practice.
true
The continuum of care is a complete range of programs and services with the type of health care indicating the health care services provided.
true
The hospital administration serves as a liaison between the medical staff and the patients.
false - the hospital administration serves as a liaison between the medical staff and governing board and is responsible for developing a strategic plan for supporting the mission and goals of the organization.
Individual state laws require healthcare facilities to obtain licenses to operate from state departments of health.
true
Describe the functions of a compliance committee.
The compliance committee analyzes legal requirements and risk areas, reviews and assess policies and procedures. The goal is to prevent and detect law violations and regulations.
Example sentence: The compliance committee meets monthly to review policies.
Distinguish between the functions of a facility’s risk management committee and utilization management committee.
Risk management committee is responsible for coordinating and monitoring risk management activities, analyzing trends of incidents, and establishing priorities for dealing with high-risk areas. The goal of the risk management committee is to ensure patient safety while the utilization management committee ensures appropriate medical care is provided.
Additional information: The utilization management committee meets bi-weekly to review patient cases.
Describe the rule of a category of active medical staff.
Active medical staff deliver most hospital medical services and perform significant organizational and administrative medical staff duties.
Shifts can vary for active medical staff depending on the hospital’s needs.
Differentiate between the credentials committee of the medical staff and the ethics committee of the medical staff.
The credentials committee reviews and verifies medical staff application data while the ethics committee meets in order to discuss ethical problems.
Describe the medical specialty of internal medicine and primary care internal medicine and list four subspecialties that are included in the specialty of internal medicine.
Internal medicine manages common and complex illnesses of patients of all ages. Primary care internal medicine includes disease prevention, mental health, substance abuse, and wellness. Subspecialties include: Oncology, Infectious disease, Immunology, and Hematology.
Explain the purpose of the Joint Commission.
The Joint Commission provides organizations with standards, performance improvement tools, and an external evaluation of performance.
Explain the term quaternary care.
Quaternary care is an extension of ‘tertiary care’ and includes advanced levels of medicine that are highly specialized, not widely used, and very costly. Quaternary care is typically provided by tertiary care centers.
Describe the evolution of the health care system from the early prehistoric period to the present.
During the prehistoric and ancient times, healthcare was characterized by the belief that illness was caused by the supernatural. During the middle ages, medieval medicine was developed and characterized by a lack of education. Hospitals were managed by monks and nuns at this time. Modern medicine was developed during the renaissance and was based on education rather than spiritual beliefs. This medicine was characterized by a renewed interest in the arts, sciences, and philosophy.
Describe the work of the 1990 Human Genome Project.
The Human Genome Project, established in 1990, was a nationally coordinated effort to characterize all human genetic material by determining the complete sequence of the DNA in the human genome. In 2000, the human genome sequencing was published.
Describe the difference between a for-profit and not-for-profit health care facility.
A for-profit health care facility is privately owned and excess income is distributed to share-holders and owners. ex: Proprietary hospitals are owned by corporations or private foundations. A not-for-profit health care facility takes excess income and reinvests into the facility. ex: Government supported/public hospitals are supported by local, regional, or federal taxes, and operated by local, state, or federal governments. Voluntary hospitals are operated by religious or other voluntary groups.
The Joint Commission’s approach to accreditation is ______ and data-driven.
patient centered
The Joint Commission’s approach to accreditation is patient-centered and data-driven.
Quaternary care is provided most commonly at ________ centers.
Tertiary.
Example: Tertiary care centers are specialized hospitals that offer highly complex medical treatments.
The abbreviation HITECH Act means ________.
Health Information Technology for Economic and Clinical Health
No additional information.
Regulations that govern privacy, security, and electronic transactions for health care information were mandated by ________ Act.
Health Insurance Portability and Accountability (HIPAA)
No additional information.
The Health Care Financing Administration, now known as ________ was created to manage the Medicare and Medicaid programs.
Centers for Medicare & Medicaid Services (CMS)
No additional information.
Benjamin Franklin established the first United States hospital, known as the ________ Hospital.
Pennsylvania
No additional information.
Louis Pasteur and Robert Koch established the microbial, or _____ theory of disease.
Germ
No additional information.
During the Middle Ages, the most significant medical development was ________.
Medieval medicine
No additional information.
A hospital that is owned by a proprietary organization such as a commercial corporation is a for-profit facility. A hospital that is government-owned is a______ facility.
Not-for-profit
No additional information.
An interpretation of a law as written by a government agency such as CMS is called a(n) _____.
Regulation
No additional information.
Which of the following is a secondary care service?
Hysterectomy
No additional information.
What field is an eye specialist in?
Ophthalmology
Example: The patient was referred to an ophthalmologist for further evaluation.
How is a for-profit organization described?
Privately owned
What type of facilities are most hospitals in the United States operated by?
Voluntary
What type of care service involves a history and physical exam for treatment of an upper respiratory infection?
Primary
Example: The physician provided primary care services for the patient.
Which program assists with medical costs for those with low incomes and limited resources?
Medicaid
Which organization provides voluntary accreditation of healthcare organizations?
The Joint Commission
Who used a microscope to discover certain microbes that later became known as bacteria?
Leeuwenhoek
Which committee ensures patient safety by analyzing trends of incidents and establishing priorities for dealing with high-risk areas?
Risk management
No additional information
Which coding system is used in the United States to collect information about diseases and injuries and to classify diagnoses and procedures?
ICD-10-CM/ICD-10-PCS
No additional information
Which hospital department directs the facility-wide program that monitors standards of conduct, implements sanctions for noncompliance, and maintains a confidential integrity hotline?
Compliance
No additional information
Which of the following encourages the reporting of healthcare mistakes to patient safety organizations by making the reports confidential and providing a shield from their use in civil and criminal proceedings?
Patient Safety and Quality Improvement
No additional information
ICD-10-PCS is the used for the purpose of
Reporting inpatient procedures
No additional information
The National Hospital Quality Measures are standardized measures that are created in collaboration between The Joint Commission and
CMS
No additional information
Which of the following authorized the implementation of a PQRI that established a financial incentive for eligible professionals who participate in a voluntary quality reporting program?
Tax Relief and Health Care Act of 2006
No additional information
