Social Sciences Flashcards

1
Q

Model for improvement

A

incremental cycles of planning, piloting, assessing and refining an intervention to achieve a specific goal

ie. testing a new check in procedure with weekly tabulation of patient satisfaction surverys

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1
Q

Lean (quality improvement process)

A

Identification and removal or inefficiency and waste in workflow

ie streamlining scheduling to reduce excess waiting time , delays, no shows

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2
Q

six sigma (quality improvement)

A

near elimination of defects through statistically driven process improvement

ie. controlling annual incidence of wrong site surgery to <0.00001% through enhances safety measures

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3
Q

change management (quality improvement )

A

engaging personnel to adopt innovation and implement organization changes

ie. identifying frontline early adopters to lead implementation of the new EHR system

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4
Q

(100-specificity)=

A

false positive rate

specificity = 95 then 95% of people without disease will be correctly identified as not having disease

5% of people without disease will be incorrectly identified as having the disease

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5
Q

(100-sensitivity)=

A

false negative rate

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6
Q

for something to be a confounder it must be linked to what

A

both the exposure and the outcome of interest (it is not evenly distributed)

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7
Q

High sensitivity = _ false negative

A

low

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8
Q

Low sensitivity= _ false positive

A

high false positive rate

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9
Q

prescriptions for elderly patients should consider the medications what

A

magnitude of effect

time to therapuetic benefit

patient health status

goals of care

adverse drug reactions

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10
Q

how many outcomes can case-control studies evaluate

A

1

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11
Q

for patients with delirum and agitation how do you prevent falls

A

with close direct supervision

1:1 patient supervision within direct line of sight of nurses

frequent supervised toileting in patients with incontinence

optimizing the room environment (low bed, lights bright during the day and dimmed at night in dementia patients)

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12
Q

in patients with delirum and agitation what should you avoid when preventing falls

A

avoid using restraints or raising bed rails

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13
Q

how can a physician assist distressedf surrogate decision makers?

A

guiding them in applying substituted judgement

by refocusing the discussion ask what the patient was like before the illness (tell me about what she was like and what kind off goals of care she would have wanted)

help the surrogate apply their knowledge of the patients goals to the situation

emphasize shared decision making

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14
Q

genetic testing in children for diseases that have childhood onset vs. adult onset

A

child onset: test right away (like CF)

adult onsent (BRCA 1 breast cancer) - test later when the child is old enough to understand the risks and benefits of testing (to ensure informed consent)

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15
Q

Provision of clinical services primarily to reduce physician liability without significant benefit to the patient

A

defensive medicine

(leads to overuse with worse patient outcomes and higher costs)

16
Q

liability concerns in defensive medicine is addressed by

A

implementing clinical pathways or practice guidelines (evidence based recommendations for common conditions)

17
Q

what are the 4 indicators used in quality measurement to discover why suboptimal results are occuring

A

structural indicators (clinican knowledge, nurse to patient ratio)

process indicators (variations and compliance)

outcome indicators (measures in health status/outcomes)

balancing indicators ( measure of tradeoff incurred as a result of a system change)

18
Q

pay for performance systems intend to improve health care outcomes by linking financial incentives to delivery of evidence based care however, for these systems to improve orverall quality of care they must address what

A

equity (patient population)

need to consider demographic characteristics when determining the amounts of incentive payments to give physician.

19
Q

what diseases need airborne precautions

A

tuberculosis, varicella, herpes zoster, rubeola

20
Q

what do airborne precautions involve

A

N95 respirator and negative pressure isolation room

21
Q
A