Practice Issues, Trends, and Health Policy Flashcards
Living Will
Written compilation of statements in document format that specifies which life-prolonging measures one does and does not want to be taken if he/she becomes incapacitated
Which office did HIPAA come out of?
Office of Civil Rights
This means it’s a right.
PSQIA
Patient Safety and Quality Improvement Act:
1. Establishes a voluntary reporting system to enhance the data available to assess and resolve patient safety and health care quality issues
- Includes privilege and confidentiality protections for patients
- AHRQ lists patient safety organizations, which are external experts established by the Patient Safety Act to collect and analyze patient safety information
Duty to Warn v. Confidentiality
- Duty to warn supersedes the right to confidentiality if a patient’s condition may endanger others. Must warn the “others” who are in danger, and not just authorities, etc.
- Duty to protect a patient from harming him/herself supersedes the right to confidentiality
Reason Healthy People 2020 was established
- Increase quality and years of healthy life
- Eliminate health disparities among Americans
(Exam LOVES Healthy People 2020)
Mandatory Reporting
- Criminal acts and injury from a dangerous weapon
- Certain STDs
- Animal Bites
- Suspected or actual child or elder abuse
5 STDs that need to be reported
- Gonorrhea
- Chlamydia
- Syphilis
- HIV
- TB
Collaborative Practice
- Exists to enhance the quality of care and improve pt outcomes
- A “true partnership” in which all players have and desire power, share common goals, and recognize/accept separate ares of responsibility and activity
5 categories of 3rd party Payers
- Medicare
- Medicaid
- Commercial indemnity insurers
- Commercial management organizations (Insurance)
- Businesses or schools wanting health services for employees or students
Medicare A
Inpatient hospitalization, home health services and/or hospice associated with the inpatient event
Medicare B
Outpatient services
Lab/diagnostics
Medical equipment
Some home health
Medicare C
If a patient is entitled to parts A and B, they may choose to receive their services through a Part C provider organization (Insurance company)
Medicare D
Limited prescription drug coverage
Services that do not meet Medicare’s def. of phys services
- Regular physical exams (annual exams)
- Health maintenance screenings
- Counseling for well patients
(All of these are changing under ACA, but that won’t be on our exam yet)
Deming’s 3 components of continued quality improvement (CQI)
Structures
Processes
Outcomes
Structures
Inputs into care such as resources, equipment, or numbers and qualifications of staff
Processes
Includes assessments, planning, performing treatments, and managing complications
Outcomes
Includes complications, adverse events, short term results of treatment and long term results of patient health and functioning
Root Cause Analysis
A tool for identifying prevention strategies to ensure safety
RCA involves and incorporates
Inter-disciplinary experts from the frontline services
Those who are the most familiar with the situation
Identifying changes that need to be made to systems
Impartiality
To be thorough, RCA must include:
- Determination of human and other factors
- Determination of related processes and systems
- Analysis of underlying cause
- Identification of risks and their potential contributions
- Determination of areas of potential improvement
To be credible, a RCA must include:
- Participation by the leadership of the organization and those most closely involved
- Be internally consistent
- Include consideration of relevant literature
- Use the facts and ask, “So what?” to determine all possible consequences of a fact
- Include 5 Whys
