Module 3 Flashcards
Class 1
general hospitals
class 2
specialty hospitals offering general medical services limited by age/ gender i.e peds or women’s center
class 3
specialty hospitals offering a restricted range of services i.e oncology/cancer, cardiovascular heart centers–does include psych but mainly in class 4
class 4
specialty hospitals restricted to offering intensive residential treatment i.e psych
ownerships types of hospitals
federal gov’t funded – VA
non-federal gov’t
-private..usually investor-owned, for-profit where
part of the money goes back to the investors and
part goes back to the hospital
-community..usually not-for-profit, the money made
goes back into the institution
critical access hospitals
designated by CMS
- less than 25 beds
- located at least 35 mi from another hospital
- make up 72% of all rural hospitals
safety net hospitals
based on proportion of charity cases being produced
-can be both urban and rural hospitals (don’t account for distance )
urban hospitals
often larger hospital–higher bed count
- make up majority fo community hospitals
- serve densely populated areas
- usually competing with others close-by
- could be small or big
rural
smaller hospitals–lower bed count (usually 100 beds of less)
- 72% of all hospitals –critical access center
- smaller budgets
- usually serve medicaid/medicare/uninsured/underinsured
acute care
(high majority)
- short term care for illness, injury, or surgery
- average length of stay <30 days
long term care
- care typically for chronic illness, rehabilitation, or psychiatric care
- average length of stay >30 days
- most facilities will lose money if they put someone in LTC facility but they dont stay >30 days
general hospitals- general medicine and surgical services
class 1
specialty hospitals i.e mental health, cancer, cardiology
class 3(cancer, cardiology) and 4(mental health)
population based i.e pediatrics and VA
class 2(peds) and class 3 (VA)
academic (teaching) hospital
training site for physicians, needs to be associated with a medical school, usually not-for-profit institutions
community hosp v non-community hosp
community: nonfederal, short-term general and specialty hosp available to the public
non-community: not open to the public i.e VA
System
multiple facilities administered from a central office, systems can be 1 hosp or several specialty facilities or several hosp related in a sattelite type fashion
network
- groups of healthcare facilities,physicians,insurers, agencies that coordinate services
- have the same mission, vision and usually a PBM type insurance approach to care of patients (can still have satellites)
- members of a network are adminstered independently but they collab with eachother and the commuity benefits
- a system can be a member of a network
independent
independents are their own thing but can be affiliated with a network (wont be part of a system)
phamacist role in ED
personnel could be providing info on meds/pain management or could be more outpatient function where were taking med Hx and entering pts in with a good understanding of what they were taking
pharmacist role in nuclear specialty
theyre usually compounding injectable agents to help the image be more clear or highlight particular areas (or oral agents )
pharmacist role in surgery or OR
manage medications–often cretae trays specific for a provider and procedure, can be here to deal with pre/post treatment and manage pain ans anesthesiology
hospital pharmacy
- could be inpatient/outpatient
- could specialize in one or more different areas of pharmacotherapy
centralized model
traditional way oharmacies handle medication distribution
-pharmacy receives order from a practitioner in central pharmcy –> a pharmacist processes the order and verifies from central pharmacy –>pharmacy tech fills the order –> delivered to nursing unit by pharmacy tech –> nurse administers to patient
decentralized model
-dependence on automated dispensing cabinets as a primary method for medication distribution
-practitioner orders are still processed by the pharmacy
-medications have been moved closer to the patient
-nurses more convenient access (and timely)
-freeing up pharmacists time and building clinical
services
-growing, may take over centralized model
hybrid model
blend of both
-pharmacy receives an order –> a pharmacist processes he order and verifies from any location –> opt1. pharmacy tech fills the order and delivers to the unit opt2. medication released in automatic dispensing devise on unit –> nurse administers to patient
clinical pharmacist
-devise policies
-monitor ADR
-medication selection – P&T formulary
-optimizing of dosing
interaction with disciplines across the health system –including patients
buyer in selection and procurement
pharmacist or technician
- responsible for purchasing all pharmacy products within the hospital
- usually work with operational drug manager to leverage pricing
- establishes stock levels (sets minimums and maximums in automatic machine to meet the need)
- evaluate inventory turns(dont want full yr supply sitting on shelf)
- contract compliance( optimizes prices based on agreed upon pricing)
- oversees annual inventory
group purchasing organization
- negotiate drug pricing with pharmaceutical manufacturers and wholesalers to benefit its members
- groups like networks and systems have more purchasing power i.e if purchasing for 17 hospitals, likely to get discounts
Pharmacy and Therapeutic Committee
- selection
- serves in a advisory capacity to the medical staff on all matters pertaining to medications
- important to have diverse membership i.e pharmacists, doc, nurses, admins, whoever will be relevant to discussion, QI managers
inpatient prospective payment system
- bundled services unit basis
- provides payment for all non-physician services
process meseaures
- measure the success of completing an action
- how healthcare is provided
- anticipated impact on specific outcome
outocome measures
- measure the result of a specific outcome
- health status
- impacted several processes
