Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

med-tech > hsm > Flashcards

hsm Flashcards

1
Q

forces

A

The healthcare system knows a couple of structural elements that shape and impact the way it works

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

fores 1-5

A

Infrastructure
health care providers
governance
knowledge
value, politics & law

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

infrastructure

A

division of tasks and responsibilities, levels of netwerk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

healthcare providers

A

healthcare delivery institutions, medical professionals organisations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Governance

A

taking care
It is about the way the goverment controls and holds institutions that carry out public tasks accountable for what they do
in healthcare this is how defined core values

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

advisory bodies

A

boards consisting of experts who advise the government on policy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

knowledge institutions

A

organisations that generate knowledge
- universities
-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

value, politics and law

A

it starts with value, from a personal or societal perspective
These translate into political debates and law

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Vulnerability

A

is a process of increasing physical, mental and social functional shortcomings, that together significantly increase the chance on disease, disability or death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

overregulatie als gevolg van poging de zorg

A
  1. meer ondercontrollen te krijgen
  2. marktsysteem: elke actie moet geregistreerd, beprijsd
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

resilience

A

the ability to get back into the same shape or condition after a disturbing event has taken place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

redundancy

A

reserve capacity: having more resources than needed in the expected situation, having something to fall back on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

sustainable

A

a state or circumstance that enable prolonged reliable functioning of a particular system or person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

reliable

A

a system or person that functions as expected and intended. Example: high-reliability organization (HRO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

you have to start with the user experience and work back to technology

A
  • identify the user and understand what the user needs
  • recognize what the user needs is not always what he/she asked for
  • therefor you need to understand the problem

user being either the patient or the health care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

traditional healthcare model

A

revolves around the concept of DISEASE
and a rather ‘mechanical’ way of thinking and reasoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Reductionism

A

its like asking blind man what at elephant feels like: they are right (in their own area), but do not see the whole picture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What’s missing in the traditional medical approach?

A

It is not necessarily bad or disfunctional, but it has its limitations

  • focus on well-being, instead of absence of disease
  • context
  • patient role
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

WHO (1948) concept of health

A

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

–> revolves around the concept of health
–> ‘system’ way of thinking ad reasoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

narrative

A

a story (=series of related events) told among humans to explain a principle, belief or thought

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a system?

A

Multiple elements that interact and result in a situation, outcome, goal, other

Multiple elements (static, dynamic, behavioral) that interact (constantly chance) and result in a situation, outcome, goal, other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

healthcare system around the patient

A
  1. patient as a person
  2. immediately surrounding healthcare
  3. healthcare system
  4. health system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Patient-centered care and systems approach

A

system: taking all elements that are important to reach a certain goal into account
in healthcare: all elements that matter in a patient’s well-being
Or otherwise framed: all elements that impact the patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Patient-centered care/ personalized medicine/ precision medicine

A
  1. focus on well-being (what matters to you and how can we help?)
  2. context: take social context (work, family, network) and situation (life stage, live events, financial) into account
  3. different patient role: who is where and when in the lead? what does autonomy do, and mean for patient?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Levels (micro, meso, macro)

A
  • Micro: the patient as a human being: strengths, vulnerabilities, preference
  • Mese: family, friends, community, daily interactions such as work, profession, faith and beliefs
    -Macro: circumstances that patients lives and has lived in, including ‘social determinants of health’
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Social determinants of health (WHO)

A

the conditions in which people are born in, grow, live, work and age. These circumstances are shaped by the distribution of money, power, resources

  • economic stability
  • social and community context
  • neighborhood and environment
  • health care
  • education
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

paradigm/ paradigma

A

an establish (accepted) story or set of stories (narratives)

Paradigm shift: in the situation that an established story changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

System perspective

A

perspective that tries to comprehend all component and their interactions that matter for the actual health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Mapping and modeling

A

to get a better understanding of a process, a system, or an interaction between different components, visual diagrams can be used

Map: more often used for simple representation of reality
Model: for more complex, layered or dynamic representation of reality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is the purpose of modeling

A
  • Modelling is a goal to understand & clarify processes
  • A model is a deliberately chosen selection of reality
  • A model depends on the perspective and aim of the modeller
  • So, do not mistake a model for reality

Modelling is an aid to innovation
- Models can assist in finding the right treatment | innovation | policy | other by identifying leverage & friction points.
- But they can obscure matters that are important as well
- A model is a simplification of reality and subject to modellers’ choices.
- So always remain aware of the model’s objective, perspective and subjectives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

objective

A

goal; in the context of health system modelling: the question to what goal the model is designed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

perspective

A

point of view, position in the context of health system modelling: from whose point of view (patient, care provider)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

subjectives

A

influenced by or based upon: in the context of health system modelling: the elements or outcomes that are likely influenced by the modelling techniques or modellers’ choices and are therefore open to interpretation

34
Q

Elements in modelling

A

static elements, dynamic elements, behavioral elements

35
Q

static elements

A

unmoving things that nevertheless influence system dynamics, such as the environment (building, interior design)

36
Q

dynamic elements

A

circumstances that change over time, such as computer systems, climate, day/night fluctuations, but do not exhibit behaviors. (maar geen gedrag vertonen)

37
Q

behavioral elements

A

actors that show behaviors –> humans

38
Q

Actors

A

an element that participates in a system, that has a role (can both be things or persons)

39
Q

stakeholders

A

behavioral elements that have interest in systems outcomes, who can be affected or impacted

  • relatives of the patient
  • investment partners healthcare providers
40
Q

health system

A

a health system consists of organizations, people and actions whose primary intent is to promote, restore or maintain health

General speaking, the health system boundary is a country

41
Q

compare health systems (inputs/processes)

A

inputs/processes
- Payor/Provider mode: Those who pay for care, and those who provide the carel
- Expenditure dedicated to healthcare: how much money spent on providing healthcare to the total population, either as a total, or as a % of national expenditure.
- Infrastructure: Indicators such as the number of hospitals per region or capita, number of beds per hospital, No. of hospitals
- Personnel: type of medical specialists, number of healthcare workers per region, traditional healers, etc.
- Access to care: Distance to nearest hospital, care provider, etc. Access to medicines/equipment/supplies
- Health culture & norms: preference for traditional healing methods, trust in government provision of public health

42
Q

compare health systems (output/outcomes)

A
  • Patient outcomes:e.g. for individual diseases
  • Morbidity/mortality rates
  • Infant morbidity/mortality
  • Patient experience
  • Quality/safety (including all 7 dimensions)
43
Q

zorgstelselwetten

A
  • zorgverzekeringswet
  • wet langdurige zorg
  • wet maatschappelijke ondersteuning
  • jeugdwet
  • wet publieke gezondheid
44
Q

financial regulation

A

-zorgverzekeraars Nederland
- zorginstituut nederland
- zorgkantoren
- gemeenten (municipality)
- SVB (Sociale Verzekeringsbank)

45
Q

governors in healthcare

A

institutional
- raad van toezicht
- klachten commissie

external
- governance (formal regulatory institutions)
- professional associations
- steakholders groups

46
Q

what is there to govern

A
  • Quality and safety
  • privacy and data security
  • specific domain-related dangers
  • Dutch situation: market function on topics such as accessibility, competition, preventing free market excesses
47
Q

Autoriteit consument en markt (ACM)

A
  • cooperation vs compitition care providers (monopoly)
  • consumer rights
48
Q

Nederlandse zorgautoriteit (NZA)

A
  • Accessibility
  • Affordability
  • financial flow check
  • Domains: Zvw en Wlz
49
Q

inspectie gezondheid en jeugd (IGJ)

A

Quality and safety

50
Q

Knowledge actors

A

Knowledge institutions: Organisations that generate knowledge
- Universities & academic medical centres
- Institutions organised around a disease (cancer), a skill (health data centers) or function (policy)
- Institutions steering knowledge generation (e.g. through grants)
- National Healthcare Institute (|zorginstituut)

Advisory bodies: Boards consisting of experts who advise the government on policy (permanent and ad hoc)

Medical professional organisations: act in permanent and ad hoc advisory boards, answer to concerns and anticipate on expected developments (both requested and unsolicited advice)

51
Q

Financial sources

A

Primary cash flow |eerste geldstroom
Direct financing universities and academic centers

Secondary cash flow |tweede geldstroom Governmental funds (NWO, ZonMW, NHCI)

Tertiary cash flow |derde geldstroom
Private and public-private foundations

52
Q

andere actoren

A

Kennisinstituten overheid
- Zorginstituut Nederland
- NWO
- ZonMw

Internationale Overheid
- European Comission

Foundations
- Nierstichting
- Hersenstichting
- Hartstichting
- Federatie Medisch Specialisten

Kennisinstituut
Health insurers initiatives
- CbusineZ
- De huisarts bij je thuis

Sugar daddy funds
- Bill & Melinda Gates
- Open Society

Commercial funds
- Global Health Innovation

Public-private collaboration funds
- Health Innovations

53
Q

social determinants of health: economic stability

A

resources essential to a healthy life
- home (affordable)
- work (work environment)
- food (access and nutrition)
- transportation (connection to work and school)

54
Q

social determinants of health: social and community context

A

context in which people live, learn, work and play

  • Neighborhood, town, region, country
  • schools
  • work environment
55
Q

social determinants of health: physical environment

A

Environment in which people live, learn, work and play

Environmental hazards: events or substances in man-made environment or ecological system, that may cause adverse consequences for humans beings

  • Chemical (such as poisons or pollution)
  • Biological (mainly microbiological hazards (a virus etc))
  • Physical (weather conditions, flood risks, earthquakes, UV exposure, electrical etc.)
  • Psychological (aggression, intimidation, uncertainty/instability, etc)
56
Q

social determinants of health: education

A

Effects of education on health, by

  • Education resulting in higher job satisfaction and income (link to economic stability)
  • Health awareness, such as reflected in child vaccination rates
  • Health behaviours, such as in smoking, food habits, risk-taking behaviours
  • Health knowledge, such as in abilities and skills (e.g. hygiene, when to call a doctor etc.)
  • Healthcare access (understanding the system)
57
Q

social determinants of health: heathcare

A

How does health care contribute to health?
By caring for patients or curing disease

What determines its effectiveness on a national level?
- Availability or presence and Accessibility
- Quality & Safety of care delivery
- Proportion preventative care versus reactive care

58
Q

constitution

A
  • Art 11 Recht op onaantastbaarheid lichaam
  • Art 22 De overheid moet maatregelen treffen om de volksgezondheid te bevorderen
59
Q

Wet Geneeskundige behandel overeenkomst (WGBO)

A

Law on agreement in medical treatment’: a law on rights and obligations in the relationship between doctors and patients

An agreement in judicial terms means, both parties can agree on anything the want to.
This is different in healthcare, because an unequal relationship exists

The patient
Must explicitly consent to treatment, unless they are ‘not capable of giving consent’.
Right on information
Right on privacy
Can terminate the agreement

The doctor
Bound to professional standards (including refusal of procedures or treatments that a patient may demand)
Cannot terminate the agreement (but can refer)

60
Q

Dwang in zorg (Compulsory care)

A

Two Dutch laws on compulsory care:
- Compulsory Psychiatric Care | Wet verplichte geestelijke gezondheidszorg
- Care & Compulsion Act | Wet zorg en dwang

  • Acute need for compulsory care = placement in custody | Inbewaringstelling (IBS)
  • Not-acute need for compulsory care = judicial authorization | Rechterlijke machtiging (RM)
61
Q

scientific research on humans or bodily tissues

A
  • Medical scientific research act –> WMO –> all scientific research that involves humans, must be reviewed by a medical ethical board
  • Embryowet –> not forbidden, but bound to strict rules
  • Orgaan en weefsel transparatie wettem –> 3 wetten that regulate organ and tissue donation
  • privacy en persoonsgegevens –> generic law that is strictly adhered to in healthcare
62
Q

wetten innovations: medicine and medical devices

A

EU MDR –> european law regulating admissions of medical devices sinds 05/2021

Europees Medicijn Agentschap (EMA) en college ter beoordeling geneesmiddelen (CBG) –> the European and dutch boards deciding on admission of new medicine

63
Q

Wet BIG (Beroepen individuele gezondheidszorg)

A
  • Register protected professional titles
  • Defines restricted actions / proceedings
  • Professional confidentiality
  • Disciplinary law, court contains
  • three colleagues
  • two jurist
    Case submission can be done by:
  • Patients and relatives
  • Health and youth inspectorate
64
Q

medisch tuchtrecht

A

Bijzondere rechtspraak in specifieke beroepen die het algemeen belang dienen.
De gronden voor ontvankelijk zijn van een klacht (alg: onprofessioneel en/of onzorgvuldig handelen)
˗ Ondermijnen van het vertrouwen in de stand der geneeskundigen.
˗ Nalatigheid waardoor ernstige schade ontstaat.
˗ Blijk geven van grove onkunde

Maatregelen tuchtcollege
a. Waarschuwing
b. Berisping.
c. Geldboete (max)
d. Schorsing (evt. samen met geldboete)
e. Gedeeltelijke of gehele ontzegging het beroep uit te oefenen

65
Q

safity science

A
  • Born out of disasters (big and small scale)
  • A necessity to make further technological progress
  • Integrating various knowledge-domains (technical, psychological, social, design)
  • If it is successful, nothing happens…
66
Q

Thinking ahead

A

anticipate on hazards that are present, the risk they pose and how to prevent or mitigate these

67
Q

Determinisme

A

Philosophical concept, starting that all events have a pre-determined cause, that nothing is random.

68
Q

Hazard

A

a source of energy that has the potential to cause harm to a target

69
Q

Risk

A

the chance a hazard impacts a target and the severity of that impact

70
Q

(sentinel) event

A

the moment the hazard hits the target

71
Q

impact

A

the severity of consequences when a hazard hits a target

72
Q

prevention

A

taking measures that result in the hazard not impacting the target

73
Q

mitigation

A

minimizing the severity of the damage resulting from the hazard impacting the target

74
Q

scenario

A

a sequence of events, including influences from the environment (=conditions)

75
Q

conditions

A

the circumstances that (potentially) influence a process. When there are expected to have a negative impact, these are also called latent failures

76
Q

failure

A

when a danger results in harm

77
Q

cascading effects

A

when each event triggers a next scenario

78
Q

barriers

A

are measures that prevent the agent to impact the host, or mitigate the consequences of the impact

79
Q

safe by design

A

Mechanical properties: in design, materials, durability, maintenance requirements etc

Human – innovation interaction: impact on human using it | intended use versus actual use | design favouring ‘safe acts’ | ‘side-effects’ such as distraction or blind spots, influencing human performance. | etc. etc.

Imbedding in the organisation: how does the innovation fit in (potential collisions, timing etc) | can the innovation be maintained? | How is its use and implementation communicated | etc etc

80
Q

knowledge

A
  • Systems sciences studies the outcome of interactions between multiple components. This leaves the integrity of reality (better) intact and is thus likely more realistic.
  • Building models opens a possibility to simulate situations and observe the effects of experimenting (on a smaller scale, incremental and multifaceted; ergo, no silver bullets).
  • fundamental
  • translation
  • applied
81
Q

Evidence based medicine approach

A

A method to evaluate knowledge in medicine

  1. defining the problem/ clinical question –> assess, Ask,
  2. search literature –> Acquire
  3. critical appraisal of evidence –> Appraise
  4. implement –> apply
  5. Accept
82
Q

bias

A

A disproportionate weight against/in favor of.. or skewed representation of.. due to mostly unconcious processes or unnoticed flaws in research design

med-tech (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions