Healthcare Admin Flashcards
A concise statement that describes the ideal state to which an organization aspires
- provider of the service
- actual services provides
- target clients
- quality declaration that identifies aspirations for how audiences will perceive the program
vision statement
a written expression of an organizations philosophy, purposes and characteristics
- help AT direct resources
- inspire Ats to do a good job
- action oriented
Mission Statement
Formal recognition indicating that a program meets certain prescribed quality standards
Accreditation
a data collection and appraisal technique designed to determine an organizations “weaknesses, opportunities, threats and strengths underlying planning”
WOTS UP analysis
defines organization activites in the short term, usually no longer than 2 years
operational planning
expresses an organization intended behavior relative to a specific program subjunctive
-not intended to answer detailed questions; road map (basic rules and principles)
Policies
a collection of steps designed to direct the most important tasks of an organization
- injury prevention
- injury rehab
- injury recognition
- organization & administration
processes
provided specific direction for members of an organization to follow
-procedure for discharge
procedure
the action that takes place in response to administrative problems.
- calibration
- which vendor? time of year?
practices
a method of graphically depicting the time line for interrelationships of different stages of a program
PERT (Program evaluation and review technique)
a graphic planning and control technique that maps discrete tasks on a calendar
Gannt charts
4 parts of the scope of the AT program
Athlete
Institution
Community
Clinical and corporate/industrial setting consideration
Rules from OSHA for AT Facility
- NO cleats/game equipment
- keep shoes off tables
- shower before treatment
- roughhousing and profanity not allowed
- no food or tobacco
requies justification only for those expenses that exceed those of previous budget cycle
-results in falling behind due to prices of supplies rising faster than inflation
spending-ceiling model (incremental model)
financial crisis model; requires reallocation of institutional funds, resulting in reduced spending levels for some programs ( should identify areas that could be cut w/o serious impact)
spending-reduction model
requires justicication for every budget line item without reference to previous spending patterns; requires documentation of actual program needs and development of priorities
Zero based budgeting
expenditures and revenues are projected on a monthly basis, thereby providing an estimate of cash flow; most appropriate for large, well-established sports med clinics during economic certainty
fixed budgeting
requires adjustment of monthly expenditures so that they do not exceed revenues; rarely used by school-based programs (difficult to estimate costs in advance)
variable budgeting
allocates a fixed amount of money for an entire program without specifying how the money will be spent; gives freedom to spend where it is needed
lump sum budgeting
allocates a fixed amount of money for each sub-function of a program
-expendables, equipment repairs, etc
line item budgeting
allocates funds for discrete activities; not commonly used due to expense and difficultly of analyzing specific activity costs
performance budgeting
procedure to set organization or programmatic priorities based on identifies needs
- exploration
- gather info
- decision making
needs assessment
- consider pooled buying for a quantity discount
- tap into booster clubs
- sponsorship
capital improvements
cannot be reused (tape, bandages, etc.)
expendable
can be reused (compression wraps, scissors, etc)
Nonexpendable
usually not removed from AT room (ice machine)
non-consumable capital
crutches, coolers, kits
consumable capital
document that provides vendors with the specifications for the bidding on the sale of goods and services
request for quotation
the process of bargaining (capital equipment)
- price
- supply
- quality
- shipping
- support
Negotiations
formal or informal communication used for requesting authorization to purchase goods/services
requisition
a document that formalizes the terms of purchase and transmits the intentions of the buyer to purchase goods or services from a vendor
- only do for over 200
- individual item
purchase order
process of accepting delivery goods; should be immediately checks to make sure packing slip match contents; check for damage
receiving
what should be included in risk management plan:
- security issues
- fire safety
- electrical and equipment safety
- strategies for managing risks
- risk identification
- EAP
avoid risky activity (esp when neg consequences have high cost)
Avoidance
activities associated with high financial risk but low frequency (catastrophic sports injury) or lower financial risk but high frequency (fractures, joints needing surgery)
- get insurance
- waivers signed by athletes
transference
activities with an acceptable level of risk that are viewed as part of the cost of doing business
-program must account for risks in the program budget and establish reserve funds
retention
careful development, implementation, monitoring and eval of policies and procedures can reduces risks
reduction
making inferences regarding the risk of certain activities based on clinical practice and experience
real world observation
method is difficult to implement (time intensive, costly and frequently impractical)
inference from controlled experiments
plans should cover practices, games, and conditioning sessions, should be reviewed ANNUALLY
EAP
- List of personnel involved:
(roles, responsibilities, chain of command for decision making)
- procedures to be followed in event of an emergency
communication and transportation procedures
- phone numbers
911, ATs, physicians
What to say during emergency call info:
- type of emergency situation
- type of suspected injury
- present condition of athlete
- current assistance being given (CPR)
- location of telephone being used
- exact location of emergency
- make sure keys to gate are accessible, inform members of team, assign roles, carry contact info for athletes, eap should include procedures for spectators injury/illness
eap
the process of planning for human resource needs and identifying potential candidates to meet those needs
recruitment
criteria that predict how well a candidate will perform in a role
validity
consistency of staff selection procedures
reliability
a formal document that describes the qualifications, work content, accountability and scope of job
position description
a written description of the specific responsibilities a position holder will be accountable for within the organization
job description
a written description of the requirements or qualification a should have to fill a particular role in an organization
job specification
the process of direct observation of an employee’s work, with emphasis on measurement of specific behaviors, and the subsequent development of plans to re mediate deficiencies in performance
clinical supervision
identifies the type of work that ATs do and the amount of time they spend doing it
-logging activities of ATs at randomly selected times and analyzing the nature and quality of work they are doing
work sampling
emphasizes collaboration between supervisors and supervisees to help them solve problems and develop professionally
developmental supervision
emphasizes the use of formal authority and managerial prerogatives to improve employee efficiency and efficacy (focus on achieving goals and attainment of program missions); industrial setting
inspection production supervision
Joint committee on standards for education evaluation of 21 standards in 4 categories:
- Propriety
- Utility
- Feasibility
- Accuracy
standards intended to help ensure that process is legal and fair;
- service orientation
- formal evaluation guidelines
- conflict of interest
- access to personnel evaluation reports
- interactions with evaluatees
propriety
standards intended to ensure usefulness of appraisal to workers, employers and others;
- constructive orientation
- defined uses
- evaluator credibility
- functional reporting
- follow up
utility
standards intended to help foster practicality in the evaluation process;
- practical procedures
- political viability
- fiscal viability
feasibility
standards intended to improve the validity and reliability of the process;
- defined role
- work environment
- documentation of procedures
- valid measurement
- reliable measurement
- systematic data control
- bias control
- monitoring evaluation systems
accuracy
temperature and humidity control:
max 0.75 ft/sec draft factor, 8-10 changes of air/hour, 40-50% humidity
lighting: foot candles?
illuminated at 30-50 foot candles at 4 ft above floor
taping table height
minimum of 36 inches
general treatment area requirments
30 inches between tables, electrical outlet, fluorescent light, and sliding drapes for every table
storage space?
80-100 square feet
-cool and dry at all times
1996; helps employees transfer their health insurance when they switch employers, ensures that their health information will remain private and gives people access to their own healthcare admin
HIPAA; Health Insurance portability and accountability act
1974; federal law requiring student authorization release education records to a third party and ensuring access for students to their records
FERPA; family education rights and privacy act; buckley amendment
Common elements of the PPE; 9
- health history
- physicians
- cardio
- maturity assessment
- ortho
- wellness
- special tests
- sport disqualification
- physical fitness testing
evaluated pubic hair/genitalia development in boys and pubic hair/breast development in girls; facial hair and axillary hair
-stage 1: puberty not evident
-stage 5: full development
stage 3: crucial growth plates are 2-5x weaker than joint capsule and tendon attachments
Tanner staging
organizes info around patients specific complaint
problem oriented medical record; POMR
patients past history, any personal habits, list of pt probs with brief description of the plans implemented to ameliorate those probs
cover sheet
organized by subjective and objective evaluation, assessment of pt problem, and development of a plan of treatment
SOAP notes
medical record that registers a patients complaint date, the health care practitioners action and the patients response
focus charting
type of medical record that notes only those patient responses that vary from predefined norms
charting by exception
difficult to maintain confidentiality
computerized documentation
method of recording the details of a patients assessments and treatments using a detailed prose-based format
narrative charting
act of orally recording the details of a healthcare assessment or treatment for later transcription and filing
dictation
how often should you regularly do inventory?
at least once a month -expendable supplies
makes supply management easier; stockpile in other locations only enough for 1 week
centralize storage
develop a continuous monitoring system; computerized inventory based on standard spreadsheet software
automate the inventory process
policies and procedures specifying who has access, responsibilities of those with keys
restrict access
an unplanned event capable of resulting in the loss of time, property damage, injury, disablement
accident
damage to the body that restricts activity or causes disability to such an extent that the athletes to practice or compete the next day
injury
athletes in all sports in the pan of 1 year face a ___ chance of sustaining some injury
50%
% of muscle contusions. lig sprains and muscle strains?
90%
% of microtrauma complications that lead to chronic conditions
10%
most common sports injuries? male and female?
sprains/strains, fractures, dislocations and contusions; knee is highest then ankle and upper limb; males have shoulder/upper arm injuries
4 most common cause of deaths in AT
- chest impact
- struck in the head
- direct blow to the head
- playing structure falling on athlete
indirect sports death?
heatstroke; the cardiovascular, respiratory or congenital conditions
nongovernmental, nonprofits public service organization that draws sports from a variety of sources, including educational institutions
National Safety Council
conducted at UNC- CH since 1965; data collected about school, college, pro, and sandlot football through personal contact interviews and questionnaires
Annual Survey of Football Injury Research
complies research on catastrophic injuries at all levels of sport
National Center for Catastrophic Sports Injury Research
established in 1982; studying incidence of football injuries so that rule change recommendations could be made; 2004 full web based for lower cost
NCAA Injury Surveillance System
established as a part of the consumer product act of 1972; data on injuries related to consumer projects are monitored from a selection of hospital ERs; sport injuries are 25%
National Electronic Injury Surveillance System; NEISS
the state of being legally responsible for the harm one causes another person
liability
liability generating conduct associated with the adverse outcome of patient treatment
malpractice
reasons for liability
- negligent patient care
- failure to obtain informed consent
- intentional conduct
- breach of contract
- use/transfer of a defective product
- abnormally dangerous treatment
failure to obtain informed consent
negligence
assumes that an individual is neither exceptionally skillful nor extraordinarily cautious, but is a person of reasonable and ordinary prudence
standard of reasonable care
a legal worng, other than breach of contract, for which a remedy will be provided, usually in the form of monetary damages; 3 types
tort; intentional tort, negligent tort, and strict liability tort
Types of negligence
- nonfeasance/act of omission
- malfeasance/act of commission
- misfeasance
when an individual fails to perform a legal duty
nonfeasance/act of omission
when an individual commits an act that is not legally his to perform
malfeasance/act of commission
when an individual improperly does something they have the legal right to do
misfeasance
states that neither the government nor any individual who is employed by the government can be held liable for negligence
Sovereign immunity
provides limited protection against legal liability to any person who voluntarily chooses to provide first aid; cant be used in by AT in work setting
Good Samaritan Law
to prove negligence, plaintiff must prove 5 components?
1. conduct 2, existence of duty 3. breach of duty 4. causation 5. damage
must prove AT did something that links him to case by omission or commission
conduct
duty to provide services to athletes actively engaged in the institutions athletic programs
existence of duty
desertion of patient-practitioner relationship by the healthcare provider without the consent of the patient
abandonment
the degree to which a healthcare practitioner’s action are associated with the adverse outcomes of a patient’s care
actual cause
the degree to which the harm caused by health care practitioner was foreseeable
proximate (legal) cause
sets a specific length of time that an individual may sue for damages for negligence
statute of limitations; 1-3 years or 3 years after 18 yr old
injured plaintiff understood the risk of an activity and freely chose to undertake the activity regardless of the hazards associated with it
assumption of risk
the degree to which a plaintiff contributed to the harm by the defendant
comparative negligence
- Administer PPEs
- Monitor fitness levels
- Assess activity areas
- Monitor environmental conditions
Preparation for activity
- Maintain equipment
- use proper instructional techniques
- provide adequate work-rest intervals
conduct of the activity
- have a physician supervise all medial aspects of the program
- evaluate and treat injuries correctly and promptly
- supervise student athletic trainers
injury management
- document physician orders
- document the treatment plan
- document the treatment record
- document the patients progress
records management
liability of any or all partied along the chain of manufacture of any product for damage cause by that product
product liability
risk of injury from use of product was foreseeable and company did not exercise due care in reducing or eliminating risk
negligence
patient using its product is injured, regardless of the foreseeability of risk or the care the manufacture took to prevent the injury
strict liability
product is found to be unfit for the purpose for which it was intended manufacturers of athletic equipment are strictly liable for defects in the design and production of equipment that reduces injury
breach of warranty of fitness
manufacturers written statement that a product is safe
express warranty
contract between policyholder and insurance company to reimburse a percentage of the cost of the policyholders bills
medical insurance
more comprehensive; reimburses cost of preventative as well as corrective medical care
health insurance
contract between an insurance company and an individual or organization
policy
situations or circumstances specifically not covered by an insurance policy
exclusions
additions to standard insurance policy that provide coverage for conditions that are not normally covered
riders
invoiced cost of insurance policy
premium
portions of any claim that is not covered by the insurance provider; the amount of expenses that must be paid our of pocket before an insurer will cover any expenses
deductible
capped contribution defined in the policy and paid by an insured person each time a medical service is accessed. it must be paid before any policy benefit is payable by an insurance company
copayment
insurance designed to protect an athlete against future loss of earnings because of a disabling injury or sickness
disability insurance
cover AT in civil cases not criminal:
- claims made
- tail coverage
- occurrence policy
only covers claims made during the calendar year
claims made -cheapest
covers things outside of the policy year
tail coverage
covers any incident during the policy year
occurrence policy
insurance designed to provide lifelong medical, rehab, and disability benefits for the victims of a devastating injury
catastrophic insurance
designed to cover school employees, officers, and the district against suits claiming malpractice, wrongful actions, error and omissions, and acts of negligence
error and omissions liability insurance
institutions with this type are speculating that the amount they pay out for the medical expenses will be less than the amount they would pay for insurance premiums
self insurance
a type of health/medical/accident insurance that beings to pay for covered expenses immediately after a deductible has been paid
primary coverage
insurance that begins to pay for covered expenses only after all other sources of insurance coverage have been exhausted
secondary insurance or excess insurances
form of state credentialing, established by statue and intended to protect the public, that regulates practice of at rade or profession by specifying who may practice and what duties may be performed
Licensure
unlicensed individuals are not allowed to call themselves ATs
name protection
unlicensed individuals are not allowed to perform tasks reserved for ATs under law
service protection
a form of title protection, established by state law or sponsored by professional associations, designed to ensure that practitioners have essential knowledge and skills sufficient to protect the public
certification
is pa a certification or license?
certification
type of state credentialing that required qualified members of a profession to register with the state in order to practice
registration
a legislative mechanism used to release members of one profession from the liability of violating another professions practice act
exemption
the process by which medical vendors receive reimbursement from insurance companies for services provided to policyholders
third party reimbursement
type of traditional medical whereby patients are free to seek medical serviced from any provider; plan covers a portion of cost of covered procedures and patient is responsible for the balance
fee-for-service/indemnity plan
type of insurance plan that requires policyholders to use only those medical vendors approved by the company. all medical services are coordinated by a primary care physician, who acts as a gate keeper to specialty services
health maintenance organizations (HMOs)
type of insurance plan that provides financial incentives to encourage policy holders to use medical vendors approved by the company
preferred provider organizations (PPOs)
managed-care model whereby an HMO provides health care serviced through a network of individual medical practitioners
Individual practice association (IPA)
medical services are reimbursed only if patients used contracted providers
Exclusive provider organization (EPO)
similar to PPOs, except that primary care physicians are assigned to patient to coordinate their care
Point of service plan (POS)
government sponsored program for elderly
medicare
government sponsored program for the needy
medicaid
government sponsored program for members of armed forces and their dependents
CHAMPUS
coding system applied to illnesses, injury, and other medical conditions to standardize the language associated with third part reimbursement
ICD-9-CM
coding system applied to specific medical procedures to standardize the language associated with third part reimbursement
CPT; Current Procedural Terminology
