Practice Management Flashcards
Which organization creates the National Patient Safety Goals (NPSGs)
The Joint Commission established NPSGs to help accredited organizations address specific areas of concern regarding patient safety
Describe NPSGs for Goal 1, 2, 3, 7 and 9
Goal
1. Improve accuracy of patient identification (Use 2 identifiers to provide care)
- Improve effectiveness of communication among caregivers
- Improve safety of using medications
- Reduce risk of health-care associated infections
- Reduce risk of falls
What are Current Procedural Terminology (CPT) codes?
Codes for how medical pros document and report medical, surgical, etc and management services.
Requirements of CPT codes:
-Hx of problem
- Exam related to problem
- Medical decision
Define cost utility analysis.
Incorporates quality of life by considering health consequences.
How does cost-benefit analysis (CBA) differ from return on investment (ROI)
A. ROI is used prior to initiating a service (predictor of success), while CBA is used once the service is in place or started (actual success)
B. CBA only includes indirect medical benefits and costs
C. CBA includes both tangible and intangible benefits and costs
D. CBA only includes tangible benefits and costs
C. CBA includes both tangible and intangible benefits and costs
ROI does not evaluate intangible benefits and costs
According to the AHRQ, CBA allows the aggregation of health and non-health benefits because it values benefits, as well as costs, in money terms.
Define cost-effectiveness analysis.
Measures cost in dollars and outcomes in natural health units.
Cost-effectiveness= cost ($)/clinical outcomes
Define cost-minimization analysis.
Differences in cost between comparable therapies
Only useful for comparing therapies w/ similar outcomes
Define cost-benefit analysis.
Monetary value placed on therapy costs and beneficial health outcomes
What is a living will?
Legal document that states an individual’s which about how their healthcare wishes. Becomes active when a pt cannot make their own decisions.
What is a medical power of attorney?
Document that appoints another person to make healthcare decisions for them when the pt cannot make their own choices.
What is a Physician Order for Life-sustaining treatment (POLST)?
Medical order/form that is signed by MD in the healthcare setting to document end-of-life care instructions.
Is NOT a substitute for a living will.
What does HIPAA stand for and what is its purpose?
HIPPA: health insurance portability and accountability act
Purpose: protect against
1. the disclosure of health information w/o patient permission
- protect health information that is held or electronically transmitted
What is MedWatch?
System used to facilitate reporting of adverse events by providers, consumers, and industry. Designed to detect adverse event signals in the product research and post-approval phase.
FDA form 3500: used by healthcare professionals to report adverse events
FDA form 3500A: Used by industry
FDA form 3500B: used by consumers
Which of the following allows consumers and purchasers to compare and contrast the performance of health plans using the same set of measures?
A. The Joint Commission
B. Centers for Medicare and Medicaid Services
C. Healthcare Effectiveness Data and Information Set
D. Institute for Safe Medication Practices
C. Healthcare Effectiveness Data and Information Set (HEDIS)
HEDIS (Healthcare Effectiveness Data and Information Set) is a set of standardized performance measures developed by the National Committee for Quality Assurance (NCQA) to objectively measure, report, and compare quality across health plans.
Measures are developed through a committee represented by purchasers, consumers, health plans, health care providers, and policy makers
Measures include preventative care, asthma, COPD, immunizations, etc.
What is the Institute for Safe Medication Practices (ISMP)?
ISMP works w/ healthcare systems and practitioners to advocate for patient safety and promote safe medication practices.
Focus is to help practitioners understand medication error from a systems perspective, collect reports of errors and disseminate recommendations to help prevent similar occurrences.
