laatste beetje

Question 1

is there a final definition of Quality of life?

Answer 1

No
- QoL is operationally defined
- Using questionnaires QoL measures are scientifically solid

Question 2

SDM part of…

Answer 2

patient centered care

Question 3

what do numbers do?

Answer 3

• dominant
• they construct reality
• construct boundaries between disease and life
• numbers frame action

Question 4

patients describe their disease as a mystery

Answer 4

difficult to articulate when they are doing better or worse

Question 5

registries disciplined patients and doctor because..

Answer 5

sets boundaries between disease snd the rest of the patients lives
- what is the responsibility of doctors and what not?

Question 6

what role should numbers play in managing illness?

Answer 6

• numbers vs patient stories
• using numbers to make your stories

Question 7

the focus of SDM on numbers neglects:

Answer 7

• uncertainties in care
• searching character of much care
• lack of identifiable moments of choice

Question 8

how to deal with complexities in SDM?

Answer 8

• Creating flexibility in registries
• using patients input to create them
• using numbers as a start of the conversation, not the leas

Question 9

What is golden circle healthcare monitor?

Answer 9

a healthcare monitor including dashboard in consultation room

Question 10

why golden circle healthcare monitor

Answer 10

patient centred care and patient empowerment

Question 11

how golden circle healthcare monitor

Answer 11

provide outcome data to patients and professionals during whole patient journey

Question 12

dashboard objectives

Answer 12

• monitoring QoL
• Detecting abnormalities and complaints ( one clear vision)
• discussing results
• empowering patients

Question 13

benchmarking

Answer 13

measuring performance of an organization and comparing it to other similar organizations

• creates competition

Question 14

competition is central in…

Answer 14

VBHC

Question 15

how to improve?

Answer 15

improve
measure
identify areas for improvement

Question 16

structure indicators

Answer 16

number of beds
number of physicians
stroke unit
etc

Question 17

process indicators

Answer 17

waiting time
ct scan performed
etc

Question 18

different outcomes

Answer 18

• mortality
• complications
• functional outcome
• QoL
• proms

Question 19

outcomes are central in..

Answer 19

VBHC

Question 20

are health outcomes a good indicator for performance?

Answer 20

no
- case mix
- random variation

Question 21

relevance of cost measurement in VBHC

Answer 21

required for completing the value equation
- improving overall value

provides insights in the process and cost of care delivery
- process improvements
- target cost reduction

Question 22

ABC

Answer 22

• uses departments, procedures and services to analyse
• practic vs theoretical capacity

Question 23

TDABC

Answer 23

• uses patients and their conditions to analyse
• acknowledges that resources will not work full capacity
• focuses on the time it takes to complete a step in a care process

Question 24

why do we need payment reform?

Answer 24

• financial incentives influences behavior
• provider can influence demand

Question 25

bundled payment

Answer 25

one amount for the entire cycle of care for the condition

Question 26

bundled payment stimulates to

Answer 26

• minimize costs
• coordinate care well
• improve quality by reducing harmful overtreatment
• prevent complications

Question 27

limitations bundled payment

Answer 27

• unwarranted increase in bundles
• underutilizarion of necessary services
• risk selection
• compartmentalization of patients into seperate conditions

Question 28

operationalization of performance

Answer 28

• quality of care
• using process indicators

Question 29

conclusion on p4p in US hospitals

Answer 29

• there is no evidence that p4p had improved quality or patient satisfaction
• financial incentives are too weak
• numerous measures: hard to focus