Quality Assessment Flashcards

1
Q

Two aspects of quality assurance are:

A

Outcome Assessment
Retrospective Audit

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2
Q

Change in the health of an individual that is attributable an intervention or a series of an intervention

A

Outcome

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3
Q

Assessment treatment effectiveness

A

Outcome Assessment

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4
Q

It is a process used by health care professionals to assess, evaluate and systematically improve care.

A

Audit

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5
Q

It takes place before the claim of submission of services and focuses on revealing specific and targeted cases

A

Prospective Audit

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6
Q

Assessing the result of care

A

Retrospective Audit

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7
Q

Why is measuring health care important?

A
  1. Improve the patient experience of care
  2. Improve the health of populations
  3. Reduce the per capita cost of healthcare
  4. Reduce clinician and staff burnout
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8
Q

Quality PT started during the?

A

1970

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9
Q

The regulatory effort by the government

A

Professional Standards Review Organizations

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10
Q

Considered non-hospital institutional care

A

Physical Therapy

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11
Q

Assessment of organization staffing and staff qualifications, rules and policies governing professional work, records equipment, and physical facilities

A

Structure

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12
Q

It is based on the degree or extent to which the physical therapist conforms to accepted professional practices in providing services

A

Process

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13
Q

An assessment is based on the condition of the patient after care about the goals of treatment assessment of outcomes

A

Outcome

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14
Q

Proposed a system of collecting hospitals statistics in 1863

A

Florence Nightingale

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15
Q

Father of outcome patient care audit systems

A

Ernest Codman

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16
Q

Qualified health professionals
will=__________

A

Good care

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17
Q

What organization happened in 1952?

A

Joint Commission on Accreditation (JACAH)

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18
Q

What happened in 1965?

A

utilization review for Medicare funding

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19
Q

What happened in 1972?

A

Bennett Amendment of social security act (PSROs)
- Review of PT service

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20
Q

2 MAJOR FORCES INFLUENCING
QUALITY ASSURANCE
DEVELOPMENT IN US (United States)

A
  1. JCAH
  2. PSROs
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21
Q

performance evaluation procedure (PEP)

A

JCAH

22
Q

The standard for PT services and standards for PT practitionerprofession statement of conditions and performances which are essential for quality
physical therapy services and
patient care

A

APTA

23
Q

QUALITY ASSURANCE STANDARDS WHERE IS ESTABLISHED BECAUSE OF:

A
  1. Reluctance of health
    professionals to objectively
    evaluate the quality services they
    provide
  2. An informed public
  3. Spiraling cost of health care
24
Q

SOCIAL SECURITY ACT OF 1972 (THREE OBLIGATIONS)

A
  1. Order or Furnish
  2. Furnish
  3. Provide
25
Q

Only care is medically necessary

A

Order or Furnish

26
Q

Meet professionally recognized
standards of quality

A

Furnish

27
Q

_______ documentation of the medical necessity and quality of care provided ass the PSRO may reasonably require

A

Provide

28
Q

Quality assurance system focuses on:

A
  1. monitoring the results of care
  2. assessing the results of care
  3. Improving the results of care
29
Q

A process in which criteria or standards are used to
review actual practice to identify those areas requiring in-depth study or to determine the results
of corrective action.

A

Monitoring

30
Q

This is done through retrospective patient care audits. The area of concern becomes the audit topic.

A

Assessing the results of care

31
Q

The corrective action that must be implemented

A

Improving the results of care

32
Q

The audit has four distinct steps:

A
  1. development of screening
    criteria
  2. Data Retrieved
  3. Data Display
  4. Data Analysis
33
Q

The criteria should be designed to screen out records most likely representing acceptable patient
care from a direct physical therapist

A

Development of screening criteria

34
Q

This information indicates whether the record/data gathered satisfied the element

A

Data Retrieved

35
Q

Summarizes the medical data analyst review of all records

A

Data Display

36
Q

It records that did not satisfy screening criteria to determine the quality of care

A

Data Analysis

37
Q

Patient care responsibilities of
managers:

A
  1. Managing Professionals
  2. Utilization Management
  3. Case Management
  4. Quality Care
  5. Patient Satisfaction
  6. Patient rights and responsibilities
38
Q
  • do not have direct responsibility for individual patients
  • direct patient care responsibility
    belongs to each physical therapist
  • assist with nonclinical problems;
    provide performance feedback; and reaffirm the Vision, mission, and goals of their organizations
  • heavy workloads, interprofessional role conflicts or
    ambiguity, scarce resources, understaffing, physical strain, emotional labor
  • interpreting the big picture of healthcare policy,
    reimbursement, and organizational goals
A

Managing professionals

39
Q

-Responding to the efforts of third-party payers to manage their costs and the quality of the care
-conditions that are the costliest, most utilized, or result in questionable outcomes receive the greatest scrutiny
- determine whether patient care is
efficient, effective, medically necessary and appropriate
- quantity of services, the timetable for
delivery, and appropriate sources
of evaluation and treatment
- received a level of care that was
efficient, effective, and
consistent

A

Utilization Management

40
Q
  • meet a person’s needs through available resources
  • duties of case managers may include:
  • Screening to identify appropriate patients
  • Planning and coordinating the
    delivery of care
  • Evaluating the outcomes of care for each patient
  • Checking benefits available and coordinating with other benefits
A

Case Management

41
Q

defined as the degree to which a healthcare organization increases the likelihood of desired health outcomes, consistent with current evidence about the scientific, interpersonal and organizational
components of healthcare

A

Quality Care

42
Q

Healthcare quality with six
dimensions of patient care:

A
  • Safe
  • Effective:
  • Efficient:
  • Timely:
  • Patient-centered:
  • Equitable:
43
Q

Quality defects can be classified as:

A
  1. Underuse
  2. Overuse
  3. Misuse
44
Q

Failure to employ many scientifically sound practices as often as they should be

A

Underuse

45
Q

Failure to eliminate diagnostic tests and interventions when they are not indicated

A

Overuse

46
Q

Failure to appropriately execute the proper clinical care process

A

Misuse

47
Q

Two critical aspects of patient satisfaction

A
  1. Content of quality
  2. Service-delivery quality
48
Q

It depends on performance evaluations, staff development, compliance with evolving guidelines and standards

A

Content of quality

49
Q

It depends on managers having processes that meet patient expectations for convenience and
timeliness

A

Service-delivery quality

50
Q

A list of guarantees while receiving
medical care, which may be a voluntary declaration developed by an organization for its own
members or goals

A

A bill of rights