quiz two Flashcards
Affordable Care Act:
- Law enacted in 2010 to improve health care quality while lowering cost and expanding eligibility for the Medicaid program to include all adults with low incomes below a certain level of the federal poverty level
- Also concerned with disease prevention. Clients are encouraged to sign up for insurance and seek preventative care before they become ill so that they can stay healthy.
- Provides coverage for Americans who previously were unable to obtain insurance coverage due to preexisting conditions.
happens from an outside organization that assures they have policies and procedures in place to maintain the quality of services and the safety of clients
accreditation
is a sign to the public and other organizations that the organization is committed to quality and that the organization has high standards of practice
accreditation
○ A nonprofit organization that accredits health care organizations in multiple types of health care settings (inpatient hospitals to pharmacies)
○ Sends experienced surveyors who are experts in their respective field to perform the visits.
○ Visits often consist of documentation and policy review, observations, and interviews with administration and staff members to ensure quality and safe client care and identify areas for improvement.
○ Accreditation is not valid after three years
○ Monitors state legislative and regulatory changes and updates its standards accordingly
The organizations must be able to explain to TJC surveyors how they meet the elements of each standard either through discussion, by demonstration in chart review, or through written procedures and policies.
the joint commission
○ Organization that focuses on improving the quality of health care through the development of evidence-based standards for care.
National Committee for Quality Assurance
An organization that supports nurses to improve client care through education, certifications, and professional designations. Developed magnet status
American Nurses Credentialing Center
national accreditation agency concerned with continuous quality improvement of nursing programs across the academic spectrum. Nursing programs must provide a systemic self-assessment of the program addressing institutional support and the accreditation standards for quality nursing education.
NLN commission for Nursing Education Accreditation
an adverse event that should never occur, usually results in client’s death or harm that is determined to be permanent or severe. Examples include administering wrong blood types, infant death, surgical procedure performed on incorrect limb. These events are reported to TJC to improve systems-related issues and to improve client safety and quality of care.
Sentinel Events
uses broad range of standardized questions to measure and compare client satisfaction between healthcare facilitates. Is administered randomly to clients 48 hours to six weeks after discharge. Scores are publicly reported to ensure transparency.
Hospital Consumer Assessment of Healthcare Providers and Systems
popular survey tool to measure health care delivery and client satisfaction in acute care agencies. Has metrics on access to care, wait times, client interactions with the health care team, and the visit itself. Is emailed to every client at the conclusion of their visit.
The press ganey
government health care coverage for a client who is age 65 or older or with disabilities or any age with end stage renal disease or amyotrophic lateral sclerosi
Medicare
(hospital insurance) hospitalization, skilled nursing facilities, some hospice care, some health care
Part a of medicare
(medical insurance) doctor’s services, physical therapy, occupational therapy, some health care
part b of medicare
(advantage plan) selected coverage that can include Medicare parts A B and D
part c of medicare
(medication coverage) extra coverage to lower costs of prescription medications
part d of medicare
government health care coverage for a client who must meet eligibility requirements based on the client’s income in relation to the poverty level. Income eligibility varies from state to state
medicaid
benefit of employment for many people. Employer chooses the coverage and individuals still face out of pocket expenses.
employer sponsored health insurance
a fixed amount of money a client must pay before health insurance begins to cover, calculated annually
Deductible
physician or NP or PA that can screen the client and treat them for routine illness, promote wellness, and prevent disease. May also refer to specialist.
primary care facility
a fixed amount a consumer pays for health care typically at the time of the care or services are received.
copay
focuses on preventive services, caring for clients before admission to facility. The work is don’t on a population. Goal is to education the community to eat better, exercise, and partake in preventive care measures.
community care facility
requires treatment in an emergency department or an overnight stay. Brief short admission to treat and stabilize episode.
acute care facility
for clients who do not need specific nursing skills but rather a place to live. May need some assistance with ADLS
long term care
long term or short term care like rehab. May also provide limited therapies like wound care and respiratory care treatments.
skilled nursing facility
specializes in clients who require hospitalization for long-term illnesses such as severe burns, trauma, or ventilation needs.
long term care hospital
provides services for clients who are mostly independent but choose to live in a community setting for assistance with some part of their daily life.
assisted living
provider has determined the individual has less than six months to live
hospice
