Health Care Systems: Health care delivery Flashcards
What purpose does The Joint Commission and the National Committee for Quality Assurance serve?
Set standards for facilities to develop policies and procedures to ensure the care patients receive is both of high quality and safe.
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a tool used to do what?
Improve care delivery to patients.
Nursing excellence programs (Magnet Recognition Program and Pathway to Excellence Program) serve what purpose to the nursing profession?
Make nurses happier. Happy nurse means high retention and low turnover rates.
What is the difference between the Magnetic Program and the Pathway to Excellence?
- Magnet Program:
- Maintaining high quality patient outcomes
- Observe and implement new practices nurses come up with.
- Pathway to Excellence:
- Improve communication between intra and interdisciplinary teams
- Harbors a supportive environment
- Aims to make nurses lives easier.
With that being said about the two programs you could say the main focus of each is?
- Magnet program: Make the nurses job more efficient so they can provide quality care.
- Pathway to Excellence: Creating a healthy work environment.
What does insurance reform refer to?
Changes reimbursement structure for healthcare.
Besides race and ethnicity, healthcare disparities also relate to?
Social, economic, and environmental differences.
(T/F) States have little power to enact legislation to control healthcare costs and instead can implement procedures that can alter cost in other ways.
True
What is an example of a way that states altering healthcare cost, other than through legislation.
Change definitions of chronic illnesses to help control reimbursement.
(T/F) States cannot put a cap on pharmaceutical prices to help control market costs.
False, states can put a cap on pharmaceutical prices.
Part A of Medicare covers?
- Hospitalization
- SNFs
- Some hospice care
Part B of Medicare covers?
- Doctor visits
- OT/PT
Part C of Medicare covers?
- Prescription drugs
How does one qualify for Medicaid?
Income based.
What is the purpose of Children’s Health Insurance Program (CHIP)?
Provide insurance to children who may not meet Medicaid requirements.
What is our responsibility as a nurse to discuss private insurance with our patients?
It’s not. Next card.
As far as education goes, how does this vary between an RN vs a PN?
RN: Will educate and teach
PN: Can reinforce teaching under the guidance of an RN or Provider
What is the objective of a primary care provider?
Manage your health needs through referring you to specialists, ordering diagnostic studies, and etc.
(T/F) Your PCP can treat a respiratory problem you are experiencing?
True. If you do not improve, then they can refer you to a specialist.
What is the objective of a community care setting?
Preventative services.
Care for patients before they need to be treated at a health facility.
What are some preventative services provided by a community care setting?
Education on eating well, exercising, and what to look for in certain acute situations, like strokes or heart attacks.
Acute care setting vs Long term care facility?
Acute care: Treatment in ED or brief(ish) stay in a hospital.
Long term care facility: A place for patients who do not require specific needs and just need a place to live.
How does a skilled nursing facility vary from a long term care facility?
SNFs may provide short-term rehabilitation like OT and PT, as well as provide IV fluids, wound care, and respiratory treatments.
How does a long term care hospital vary from a SNF or long term care facility? Examples?
A place for patients with long term illnesses to stay at.
Examples: severe burns, trauma, or ventilation needs.
Objective of an assisted living facility?
Encourage independence for patients, but still provides 24-hour supervision/assistance to meet needs.
(T/F) Hospice care and palliative care are the same thing?
False.
Hospice: Goal is to provide comfort when patient decides to no longer receive care/treatment for their illness.
Palliative: Goal is to provide comfort, but patient is still receiving care for their illness.
What does respite care provide for patients and family?
Respite care provides caregivers to families when they need a break from caregiver responsibilities for a short time.
What does home care services provide?
Nurse comes to home and performs assessments and obtains lab samples or provides wound care, antibiotic administration, and other nursing tasks.
