*Health Care Sys: HEALTH CARE DELIVERY Flashcards
Sentinel events
An event that results in client death or permanent severe harm
The joint commission
Non profit organization that ACCREDITS Health Care organization. For examples Hospitals
Examples of sentinel events
blood transfer is incorrect
infant death
wrong body part amputated
National Committee of quality Assurance (NSQA)
Accredits HEALTH CARE PLANS, PROVIDERS, FACILITIES, CASE MANAGEMENT COMPANIES. Focus on improving health care through development and administration of evidenced base standards.
American Nurses Credentialing Center (ANCC)
2 programs. It recognizes quality nursing practice and receive award
Magnet Recognition Program
awards health care organization that provides excellence in nursing care
Pathway to excellence Program
award facilities that demonstrate a commitment to providing a healthy workplace for their staff.
Magnet Recognition Program Identification
Focus on facility
ID organizations with quality outcomes.
ID clients care excellence
ID innovation in professional practice
Pathways to Excellence Identification
Focus on staff
ID contribution that affects nurses well being
ID a supportive practice environment
ID a shared governance structure
Press Ganey
Survey tool designed to evaluate care delivery. client satisfaction
HCAHPS
evaluate client satisfaction
Medicare
65 y/o +.
What are the parts of medicare
three parts
A. hospitalization
B. Doctors services
C. Prescription drugs
Medicaid
government healthcare coverage for a client who meets qualifications
Palliative Care
provides service that help clients feels as comfortable as possible while still receiving treatment
Respite care
gives the caregiver a break
Dx Relaxed Group (DRG)
a payment system to reimburse for the health services based on the clients dx and procedure performed
Goal of ACA
improve health care quality and increase access to service
Five social determinants of health
- Economic stability
- Education
- Social and community context
- Health and health care
- Neighborhood and built environment
Occupational therapist
recover or develop new skill to maintain ADL
Physical therapy
recover from injury or illness. help with client to improve movement
case manager
facilitates treatment plan, finds cost effective care
health care disparities
social economic and environmental differences that affect health status
Nurse calling pts insurance before exam is called?
Precertification
A nurse is reviewing a report by the IOM. which competencies should the use ID to reduce error
cooperation
communication
coordination
Post Ganey survey is delivered by which method?
Minimum Data Set assessment includes ?
input from interdisciplinary team
clients cognitive status
each physical therapy visit
clients need for ADLS
The nurse is teaching another nurse about TJC. which of the following info should the nurse include?
TJC ensures organization remain up to date with state guidelines
Physical determinant
poor air quality. physical environment. ex. leaky pipes
HACRP Hospital Acquired Condition Reduction Program
link Medicare payments to health care quality
Affordable Care Act
A focus of the ACA is disease prevention.