Roles II final Flashcards
Passing standard score for npte
600
Perfect score on the NPTE
800
when was the first licensure exam
1951
when did FSBPT take over the licensure exam
1991
who originally developed the boards exam
APTA in conjunction with professional examination srvice
the first board exam was based on ______
normative model of physical therapy
after what step of signing up for boards can you work
when you are approved to SIT for the exam
How many state agencies are there for npte
53 different jurisdictions
examples of job search strategies
networking
professional associations, linked in, indeed, hospital websites, referral source, university faculty, CSM or professional meetings
what is a red flag for timing during the interview process
if they need an answer immediately
timing of job applications
apply in batches, offer may only be good for a couple days/weeks
on average how long do people look at a resume
6-8 seconds
primary objective of a resumer
do you have the sills, training and personal attributes to be successful, include our work history
most important part of resume
clinical rotations and work experience –> will show how you fulfill a role
what does an employer assess about you
experience, education, skills, motivation, work habits, stability, perseverance, judgement, adaptability, flexibility, openness to learning, responsibility, initiative, ability to work on a team, communication skills
What are soft skills
personality, communication, flexibility–> hard to teach
what should you never do during an interview
never talk negatively about past employer, clinical placement, university
what types of questions are asked during interviews
open-ended, behavior/skills based, general questions, hypothetical, clinically based questions
STAR method
discussing difficult questions
strategy/task
action
result
Following an interview what should you do
send a follow up thank you as soon as possible
follow up later if you don’t hear back
what to do when you receive an offer
thank employer, express interest, ask for time to consider
important things to know for negotiating your salary
avg salary for that type of PT, average PT salaries in the area, awareness of number of open positions in the area, cost of living
what to do after you accept the offer
get everyhing in writing
three domains of professional identity
individual, relational, collective
individual domain of professional identity asks
who am i?
relational domain of professional identity asks
who am I in relation to others?
collective domain of professional identity asks
who am I in relation to the profession?
what does your professional identity consist of
strengths, areas for growth, professional values/interests, communication style, professional networking
new PTs who have ______ in the first ear progress more rapidly
a mentor
In the first year as a pt , the most powerful learning occurs through ______
doing
stages that new PTs go through in the first year
transition, euphoria, angst recognizing and reconciling the realities of the practice, adaptation
basic instructional level
assumes participants have little information within the areas to be covered so that the focus of the activity is a general orientation and increased awareness
intermediate instructional level
assumes that the participants have a general familiarity with the topic so it focuses on increased understanding and application
advanced instructional level
assumes thorough familiarity with he topic and focuses on advanced techniques, recent advances and future directions
residency =
prepares you to be board certified, typically newer professionals, designed to enhance therapist’s expertise in a defined area of clinical practice
fellowship
provides greater depth within a subspecialty area –> NOT FOR NEW PROFESSIONALS
residency graduates perform _____ than non-residency graduates of specialty exams
better
what shoulder tests are good for telehealth
self speeds and self hawkins kennedy
purpose of the practice act
protecting the public health, safety and welfare and provides state with administrative control, supervision, licensure and regulation of practice of PT
administrative law
need a PT license and maintain your license in order to practice
negligence
omission (or commission) of an act that a reasonable and prudent person would (or would not) do not under given circumstance
professional negligence (malpractice) definition
occurs when the alleged wrongdoer is a licensed professional and the requisite action is within the scope of practice, thus requiring the knowledge and skills of a professional
intentional tort definition
an act that is intentionally committed knowing harm is a likely result (assault and battery)
assault definition
a threat to touch another without consent
battery definition
intentional touching of another without his or her consent
false imprisonment
confinement of a person to the extent that there is no reasonable exit and physical restraint was not necessary
defamation
communication to a third party or parties that that is unfounded and negative to their character (slander and libel)
fraud:
intentional misrepresentation in a manner that could cause harm `
what things need to be proven for negligence?
duty, breach, damages and causation
duty
duty owed to a person: occurs when a HC facility or provider undertakes care/treatmentc
corporate liability
company has a duty to hire qualified staff and supervise employees and monitor employee performance
Breach=
duty was not met, failure to act or failing to meet the standard of care
direct damages=
lost wages, current and future medical expeses
indirect damages=
value for pain, emotional distress and loss of consortium, loss of companionship is big
punitive damages
added with conduct was intentionally harmful or so negligent that it demonstrates a willful disregard for a standard of care
causation
causal relation between the breach of duty and damages that occurred
what is a summons
written legal document given tot he defendant naming them as the defendant, the plaintiff, jurisdiction and when/where to appear
what is a complaint
gives details about the case against the defendant and outlines the basis of the suit
what happens in a discovery
written and oral depositions, request for production of records
civil fraud
claiming a certain care plan will cure patient while knowing that it will not
criminal fraud
billing for services that were never rendered
when is harassment unlawful
when it is offensive to become enduring and a condition of continued employment or conduct is severe or pervasive enough to create a work environment that a reasonable person would consider intimidating, hostile or abusive
most common injury claims are
fractures, burns and increase/exacerbation of symptoms
most closed claims come from
falls, reinjury, burns and private practice
what class experiences the most allegations
professional conduct
how to minimize risk of allegations
communicate effectively with pts, families and colleagues
delegate only when appropriate and never leave treatment area when pt receives treatment from another level of staff
adopt an informed consent process that involves discussion and teach-back, follow documentation standards, avoid documentation errors, maintain clinical competencies specific to the patient population, be safe, recognize the patients comorbidites/condition that may affect treatment, respect pts, monitor environment for safety and know/comply to the state laws
overt problem
noncompliant event that is obvious or easily seen
covert problem
noncompliant event that is not obvious or easily seen
what is a trend analysis
review and assessment of data taken over a period of time with the intention of identifying patterns in the organization
occult problems
noncompliant event that is deeply hidden and cannot be identified without an in-depth investigation
most important aspect of effective grassroots campaign
personal relationship with legislator
how to build rltp with legislator
office visit, practice visit, town halls, fundraisers
be prepared, be unified, be informed
who elects all members of board of directors
house of dlegates
if we have a concern where would we take it
brought to board member of assembly member of the chapter
what is consultation for a physical therapist
professional/expert opinion or advice
identifying problems, recommending solutions and produce a specific outcome in set amount of time
What is general supervision:
PT is not required to be on site for direction and supervision, but must be available at least by telecommunications
What is direct supervision:
PT is physically present and immediately available : can not be through telecommunications
Direct Personal Supervision
PT or PTA is physically present and immediately available to direct and supervise tasks that are related to patient/client management. The direction and supervision is continuous throughout the time these tasks are performed. Telecommunications does not meet requirement of direct personal supervision
How long is a PTA program
2 years
What can’t be delegated to a PTA
Interpretation of referrals, examinations, PT diagnosis, develop POC, conducting re-exams, overseeing care/documentation/progress, discharge, screening (if it is during exam), dry needling, joint mobilizations, sharp debridment, or any situation with unstable response
Consider when delegating
PTA education, training and skill level
Patient/client complexity, stability, criticality, acuity
Predictability of the intervention
Proximity of the PT
Supervision available with emergencies
Other things to consider with delegation to PTA
Type of setting
Federal or state statute
Liability and risk management
Mission of PT services for the setting
Needed frequency of re-examination
When does off site PTA supervision HAVE to be made
At least once a month, or at higher frequency when established by the PT, in accordance with the needs of the patient/client
Need to have on-site reexamine, on-site review of the POC with appropriate revision or termination, evaluation of need/recommendation for other resources
If a change in medical status or POC or discharge is needed what does the PT and PTA do
PTA delegates to the PT an PT must perform re-eval
Who is responsible for PTAs (direction and supervision)
the PTs
PTAs assist with __________ aspect only
Intervention
What type of supervision does Medicare require for PTAs in Private Practice PT
Direct on-site
Is Part B covered for students in Medicare
No unless directed by PT and supervision has to be Direct
Where can you look for information for PT and PTA information
APTA, payer website, practice act, supervisor or legal counsel of organization
other definitions of a PT consultant
An individual to whom one refers for expert advice or services
A person who gives professional advice or services to a company for a fee
A person who by training and experience has acquired special knowledge in a
subject area that has been recognized by a peer group
A PT consultant is not an employee of the company but works as an _________ ________
independent contractor
attributes of a good consultant
expertise, objective, communication skills, good listener, professionalism, team player, ability to see multiple points of view, problem solving skills
Phases of consulting
Entry and contracting
data collection and diagnosis
feedback and decision to act
implementation
extension, recycle or termination
what happens during the feedback and decision to act phase
report findings in a manageable way
involve the client in analyzing
be prepared for resistance
set goals within a timeframe
determine steps to action
what happens in the entry and contracting phase
meeting with client
exploring problem
decide if you’re the right consultant
listing clients’ expectations
specify your expectations
determining how to get started
what happens during the extension, recycle or termination phase
evaluate success or failure
extend or recycle service if real problem is discovered
terminate if goals met
what do you need to know/have in a consulting agreement
statement of independent contractor
description of scope of services
terms and conditions like resources, fees, expectations, purpose/objectives and termination circumstances
date of service
who will own any intellectual property that develops out of the project
signatures
why does healthcare reform matter to us
payment and legal issues
what year was the american disabilities act
1990
when did HIPPA law enact and what was it’s impact
1996
established pt privacy and continuity of healthcare
enhanced penalties for fraud and abuse
established medicare integrity program
when was the affordable care act enacted
2010
G codes were enacted under what bill and when
2012 under the Middle Class Tax Relief Bill
Describe the impact act of 2014
improved medicare acute care transformation act
enacted standardized data submission for all post-acute care facilities
what are the four modes of healthcare financing in the US
out of pocket
individual private insurance
employment based group insurance
government-social insurance model
Describe a Preferred Provider Organization insurance (PPO)
can see any provider in network without referral (may not be the case with PT) , in-network costs are significantly lower
Describe Health Maintenance Organization (HMO) insurance
you must have a PCP who directs all services to in-network members/specialists
what is point of service insurance
cash based model
describe a High Deductible Health Plan (HDHP)
healthcare plan with high initial deductible cost but lower yearly or monthly premiums
who owns ICD-9 and ICD-10 codes and what are they
World Health Organization
diagnostic codes
Who owns Procedure codes and what are they
its what PT did
owned by American Medical Association
where are procedure codes required
private practice, outpatient hospital, medicare part B SNF payment
a lot of people that are underinsured also are ____
below federal poverty line
consequence of uninsured
no usual source of care
less likely to have been seen by HC provider in last 6 months
unmet needs
worse healthcare outcomes
huge financial burden
what was the affordable car act
identified essential health benefits
employer and individual mandates
reduced the uninsured
what are the 10 essential health benefits from the affordable care act
ambulatory patient services
emergency services
hospitalization
maternity/newborn care
mental heath/substance abuse/behavioral health
prescription drugs
rehab abd habilitative
laboratory services
prevention and wellness services
pediatric (oral and vision included)
are the minimum benefits the same in each state
no
what does affordable mean in the affordable care acts employer mandate
employee’s contribution does not exceed 9.5% of household income
what are applicable large employers
defined as averaged t lest 50 full time equivalents during previous calendar year
what was the individual mandate in the affordable care act
individuals must have insurance for themselves and any dependents
failure to do so will equal monthly penalty on tax return
exceptions to affordable care act
can’t afford
incarcerated
individual is not lawfully in U.S
refusal of healthcare due to religious beliefs
members of indian tribes
Affordable care act eliminated ______
adverse selection: insurance companies couldn’t deny someone with worse health just because it would cost them more
what is the medical loss ratio
insurers who do not spend 85% (large market) or 80% (medium market) on the insurer health costs, must provide rebate to consumers
who qualifies for medicaid
earn less than 138% of FPL
100% poverty line for family of 4
$30,000
medicaid enrollees are
sicker and more disabled
what is quality care
means doing the right thing at the right time in the right way for the right person and having the best results possible
What is the Hospital Readmissions Reductions Program
if medicare pt returns with new admission within 30 days of discharge than the government punishes the acute care hospital
ACOs share in _____ _______ with the government
cost savings
what is included in bundle payments
acute, patient hospital services, physician services, outpatient hospital services, post acute care services beginning 3 days prior to hospitalization and spanning 30 days following discharge
what is the PTs role as a researcher
we need to apply principles of scientific methods: read and interpret literature; participate in, plan and conduct research, evaluate outcome data and assess new concepts/technologies
considerations for conducting research in a clinical setting
facility or institutional resources
patient management
reporting/managing research related injury or illness
modifying or terminating the project
Purpose of research agenda for APTA
encourage programs of research among junior investigators and increase awareness of PT scientists among funding agencies
what is population research
seeks to characterize, explain and/or influence the levels of distributions of health across populations
what are the action items of population research
disparities
social determinants of health
interventions
what is health services research
how do social factors, financing systems, organizational structures/processes, technologies and personal behavior affect access to health care/total cost of HC and quality of HC
what ares are included in health services research
pt experience, personalized medicine, shared decision making
action items of health services research
delivery models
utilization and cost
payment and insurance
what is clinical research
looks at safety, effectiveness, efficacy of diagnosis and diagnostic procedures, treatment regimens and protocols, devices and technology intended for human use
action areas of clinical research
telehealth
value
treatment/interventions
what areas are included in clinical research
genomics
novel technologies
innovation
general themes of clinical research
documenting effectiveness of interventions
validating diagnostic or classification systems
accurately identifying prognostic indicators of functional limitations or disability
who is apart of the research team
PTs
Physicians
administrative support
what does the IRB do
protects the rights and welfare of human subjects recruited to participate in research activities
HC administrators must be prepared to handle
technology innovations
compliance strategies
organizational behavior
healthcare financing
human resources
health information management
facility management
quality HC policies come from
Joint commission
agency for HC research and quality (AHRQ)
case fatality %
total number of patients who died due to a specific condition/total number who were diagnosed with that condition (within a time period)
patient centered care includes
respect, inclusion, inform, comfort, support, transition
when does a direct access patient need to be referred
if not showing functional improvement after 10 visits or 15 business days whichever comes first
what is required to treat TMD
a referral
how soon do medicare certification of plan of care need to be submitted for payment
30 days
low risk definition:
probably of harm is less than 10%, harm could be minor and insignificant
high risk definition
probably of harm is likely or over 50% any harm could be major or catastrophic
moderate risk definition
probably of harm is moderate (10-50%) any harm could be moderate, preventative measures can reduce the probability
status quo phase of change
comfortable with expectations, administrator efforts needed for change
disruption phase of change
employees fearful of change and resent it, administrative efforts needed in empathy and support/training
exploration phase of change
employees let go of fears, may demonstrate benefits to change, administration needs to provide support and training as needed by ensuring opportunities for change
rebuilding phase of change
employees accept and embrace change
administrators just need to reinforce the new behaviors
competing style of resolution
assertive and uncooperative
power-oriented, standing up for your rights and what you believe as correct, individual pursues their own concerns at the other’s expense
accommodating style of resolution
unassertive and cooperative
opposite of competition
individual neglects their own concerns and satisfies the concerns of others
element of sacrifice/ selfless, generous or even yielding to someone else
avoiding style of resolution
unassertive and uncooperative
individual doesn’t pursue their own concerns or others concerns
don’t address he conflict
sidestepping the issue or postponing it
simply withdrawing
collaborating style of resolution
assertive and cooperative
opposite of avoiding
attempt to work with another person and find solution that satisfies everyone
compromising style of resolution
intermediate between assertiveness and cooperativeness
objective is to find some mutually acceptable solution that partially satisfies
gives up more than competing but less than accommodating
less exploration than collaborating
splitting difference, quick middle ground
compromising givens up ____ than competing but _____ than accommodating
more, less
