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LECOM PBL spring 2017 > HEALTH CARE MANAGEMENT II > Flashcards

HEALTH CARE MANAGEMENT II Flashcards

1
Q

who was the toyota engineer who developed much of the LEAN strategy

A

Taiichi ohno

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2
Q

what are the most valuable resources in a lean house

A

people

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3
Q

what element is develop a safe, evidence-based, cost effective, patient-centered care plan

A

element 2.4

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4
Q

what element is to apply systematic methods relating to practice based improvements and the reduction of errors

A

element 4.8

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5
Q

what element is to demonstrate patient-centered care, including the ability to build the physician-patient partnership

A

element 5.1

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6
Q

what element is to demonstrate effective written and electronic communication

A

element 5.4

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7
Q

what element is to demonstrate a commitment to excellence and to continuous learning behaviors

A

element 6.5

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8
Q

what element is to demonstrate knowledge of and ability to implement safe, effective, efficient, timely, patient centered and equitable systems of care

A

element 7.5

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9
Q

what is the goal of six sigma

A

drives improvements in quality and reliability by reducing variation

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10
Q

what is the problem solving method for six sigma

A

DMAIC: define, measure, analyze, improve and control

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11
Q

what is the goal of 5S

A

approach to waste and variability identification and elimination that relies on stabilizing the work environment

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12
Q

what does the 5S stand for

A

Sort, simplify, sweep, standardize, self-discipline/sustain

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13
Q

define contract

A

an agreement between 2 or more parties creating obligations that are enforceable in court or otherwise recognizable at law

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14
Q

what is the consultants primary function in a consulting/contractor agreement

A

prepare subsidiary for sale

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15
Q

what are the essential elements of a contract

A

offer, acceptance, consideration, meeting of the minds

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16
Q

what are the types of contracts

A

written, oral, implied/quasi

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17
Q

what is a breach

A

failing to perform any term of a contract, written or oral, without legitimate legal excuse

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18
Q

what is the definition of indemnification

A

who pays damages

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19
Q

what does integration clause mean

A

contract reflects entire understanding

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20
Q

what does ADR provision stand for

A

alternative dispute resolution

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21
Q

what is a 409A

A

deferred compensation plan

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22
Q

what is the state retention requirement of medical records after discharge of a patient in pennsylvania

A

7 years

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23
Q

what are the 4 risk management philosophies

A

avoidance, reduction of effects, transfer, acceptance

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24
Q

what are 3 three key mandates for hiring/staffing

A

hire the best; make them better (training); be an advocate for your employees

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25
Q

what percentage of physicians were self-employed in 1983

A

75.8%

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26
Q

which physicians are most likely to be practice owners

A

specialty surgeons, anesthesiologists, radiologists

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27
Q

what are accountable care organizations (ACOs)

A

groups of providers who care for a wide variety of health needs of a defined patient population

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28
Q

what are some examples of procedures done in ambulatory care

A

blood tests, imaging, endoscopy, biopsies, catheterizations, childbirth, plastic surgery

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29
Q

what type of medicine is a primary care practice with limited number of patients who typically self-pay fees for unlimited access to physicians

A

concierge medicine

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30
Q

what are the advantages of concierge medicine

A

better service for patients, better lifestyle for physicians

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31
Q

what are the negatives of concierge medicine

A

these physicians on average earn slightly less, insurance regulations, risk, marketing demands

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32
Q

what term describes leveled production, no bottlenecks or waste; studies all sequential steps in the process, the time each step takes and the time each step takes

A

heijunka

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33
Q

what is the term for safety element/be watchful for all defects

A

jidoka

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34
Q

what is the definition of kanban

A

sign: single that more resources are needed (just in time)

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35
Q

what is the definition of andon

A

light: signal for a need or problem with equipment or process

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36
Q

what is the definition of Takt time

A

paced treatment: providing service at and to meet the rate of demand from patients

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37
Q

describe one piece flow of lean

A

appropriate grouping of equipment, supplies and information; cell (work area) structure, one patient/all functions

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38
Q

describe pull treatment of lean

A

patients determine the services

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39
Q

define muda

A

waste: that which consumes resources but adds nothing of value (the worst is patient death)

40
Q

what are the 7 wastes/muda that were identified with lean

A

processing, stock on hand (inventory), movement, defective products, overproduction, time on hand (waiting), transportation

41
Q

describe sweep of the 5S structure

A

identify and remove unsafe conditions; restore everything to its proper place at days end or treatment end

42
Q

what does “par” mean in the kanban terminology

A

safe number of supply items that must be readily available

43
Q

what does sleeping inventory mean

A

that which is not needed

44
Q

what is the key formula for kanban and supply

A

daily use X lead time = minimal required inventory

45
Q

what does Kaizen mean

A

kai= incremental change; zen= refining value

46
Q

what does a kaizen officer do

A

develops action plans; clean state (take a fresh look at processes)

47
Q

what is the main goal of six sigma

A

elimination of all/virtually all defects

48
Q

what are the 7 flows of lean

A

patients, clinicians, medication, supplies, information, equipment, process engineering

49
Q

what were the goals of the saskatchewan project

A

higher quality care, reduce health’s share of the provincial budget, release dollars to programs that support health

50
Q

what was the first lean project

A

redesign of a new children’s hospital

51
Q

what are the sections for the consulting agreement

A

engagement, term of agreement, services, compensation, benefits and insurance, conflict, confidentiality, assignment/successors

52
Q

what does it mean to act in fiduciary role

A

individual that another has posed trusted to protect money and may act for another in good faith and confidence and loyalty

53
Q

what is the worst provision for the physician employee in contracts

A

covenant not to compete

54
Q

what are the essential elements of contracts that can be enforced in court

A

TACO: offer, acceptance, considerations, meeting of the minds to agree terms

55
Q

what is equitable estoppel

A

establishment with an implied/quasi contract that requires the party asserting the claim to present evidence

56
Q

when are contracts unenforceable

A

lack of mutual assent, illegality, capacity, coercion, fraud, state of frauds, parol-evidence rule, breach

57
Q

what is the definition of parol-evidence role

A

written contracts are only evidence of the agreement

58
Q

define statute of frauds

A

rule of law from 1600s (england) which requires written authorization of transfer interest in a property; cannot be transferred unless in writing

59
Q

define restrictive convenants

A

established role that one can contract to refrain from engaging in a trade

60
Q

what is the point of a restrictive covenant against competition

A

forestall unfair competition (won’t compete with employer)

61
Q

what is the point of a restrictive confidentiality covenant

A

restrict employee from using/disclosing categories of information that are deemed confidential

62
Q

what is the point of a restrictive covenant of anti-piracy covenant

A

former employee is prohibited from soliciting or inducing other employees from leaving the company

63
Q

define termination for cause

A

failure to comply with contract terms

64
Q

describe umbrella insurance

A

protects assets and future income above the standard, able to fill coverage gaps

65
Q

what is the point of employment practices liability insurance

A

protects from employee suing employers

66
Q

what are the 4 risk management philosophies

A

transfer, acceptance, reduction of effects, avoidance

67
Q

what are the 2 key principles for hiring and staffing

A

fairness and consistency

68
Q

what is the point of the national practitioner data bank- 1986 health care improvement act

A

all payments on behalf of all physicians in connections with medical liability settlements and adverse peer reviewed actions against licensee

69
Q

how many AOA specialities are there

A

18

70
Q

what are the 3Ps

A

production, preparation, process

71
Q

what is the recommended time per patient based on market demand

A

10.5 minutes per patient

72
Q

what is the job of the kaizen officer

A

develops action plans from a clean slate, educates, evaluates, etc.

73
Q

what does process engineering focus on

A

design, operations, control and optimization of processes through the aid of systemic efforts

74
Q

who developed six sigma

A

motorola

75
Q

what are the 5 steps to six signal

A

define the defect; measure (time/results/cost of defect); analyze (why does this happen); improve (whats the solution); control (maintain/sustain the solution)

76
Q

what was the biggest problem with the case of park nicollet heath services

A

sleeping inventory

77
Q

what type of scheduling was adopted by virginia mason medical center institute so that they could serve more cancer patients per day

A

cascade scheduling= staggering start times for patients and staff

78
Q

what was the biggest tactical problem with virginia mason medical center, center for hyperbaric medicine

A

difficulty bringing the chamber into the building

79
Q

what was the biggest issue with park nicollet heath services, primary care, standard rooming

A

lack of consistency

80
Q

what term describes an individual whom another party has placed the utmost trust and confidence to manage and protect money/property (acting for another’s benefit)

A

fiduciary

81
Q

what is the definition of indemnification

A

protection in case of a law suit (who pays damages)

82
Q

what term describes approval to provide specific services or practice at a particular facility

A

privileging

83
Q

what word is described as a personal trainer with the mastery of a body of knowledge

A

sensei

84
Q

what is one of the main challenges to healthcare industry

A

inefficiency of traditional hospital structure

85
Q

what is the definition of value stream

A

specific activities required to provide a specific service to the patient

86
Q

what is the floor of the lean model

A

leveled production/heijunka

87
Q

what are the 3 aspects of standard operations (lean)

A

standard work, takt time, standard work in progress

88
Q

what is the definition of greenfield

A

a new facility or process

89
Q

what is the definition of brownfield

A

established facility or process

90
Q

define catch ball process

A

goals are proposed and discussed by people all the way up and down the chain of command

91
Q

define hashin kanri

A

management by policy

92
Q

what is the goal of hashing kanri

A

gives high visibility to individual and group accountabilities

93
Q

what is the definition of gamba

A

where work gets done

94
Q

what is the definition of pokayoke

A

proofing device/procedure to prevent defects

95
Q

define muri

A

unreasonableness

LECOM PBL spring 2017 (16 decks)

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