lead 4

Question 1

____ coverage includes durable and nondurable goods, structures, and services

Answer 1

Sectoral coverage

Question 2

US life expectancy is

Answer 2

lower than in many other developed countries

Question 3

The biggest source of healthcare financing is from

Answer 3

the govt

Question 4

Almost 75% of government spending is at the ___ level

Answer 4

federal

Question 5

Medicare Part: hospital, hospice, home health, skilled nursing

Answer 5

A

Question 6

Medicare Part: provider, medical equipment, diagnostics

Answer 6

B

Question 7

The primary payer of health insurance is

Answer 7

Medicare

Question 8

Medicaid is a ____-level program

Answer 8

state (with costs shared between the state and the federal government)

Question 9

a term that means third-party payers have surveyed providers in the area to establish what the payer will pay

Answer 9

Usual and customary

Question 10

What does Managed Care mean for nursing

Answer 10

We must be able to do “financial thinking.”

Question 11

DMAIC

Answer 11

Define opportunities.
Measure performance.
Analyze opportunity.
Improve performance.
Control performance.

Question 12

QM most effective in a

Answer 12

flat, democratic, organization

Question 13

Goal of QM is to improve systems and processes, not to

Answer 13

assign blame

Question 14

Principles of QM and QI: _____ define quality

Answer 14

Customers

Question 15

QI focuses on

Answer 15

outcomes

Question 16

QA Goal

Answer 16

Improve quality

Question 17

QA Focus

Answer 17

Discover/correct errors

Question 18

QA Major tasks

Answer 18

Inspection of nurse activities;

Chart audits

Question 19

QA Quality team

Answer 19

QA or department personnel

Question 20

QA Outcomes

Answer 20

Set by QA team with input from staff

Question 21

QI Goal

Answer 21

Improve quality

Question 22

QI Focus

Answer 22

Prevent errors

Question 23

QI Major tasks

Answer 23

Review nurse activities;
Innovation;
Staff development

Question 24

QI Quality team

Answer 24

Multidisciplinary team

Question 25

QI Outcomes

Answer 25

Set by QI team with input from staff and patients

Question 26

``` Identify needs. Assemble multidisciplinary team. Collect data. Establish outcomes and quality indicators. Select and implement plan. Evaluate. ```

Answer 26

Steps in the QI Process

Question 27

Malpractice: Duty:

Answer 27

Nurse has responsibility to patient

Question 28

Malpractice: Dereliction:

Answer 28

Nurse did not carry out duty

Question 29

Malpractice: Damage:

Answer 29

Patient was injured

Question 30

Malpractice: Direct cause:

Answer 30

Injury secondary to the nurse’s failure to carry out duties