Test 2 Flashcards
What are 5 function an HCO’s clinical organization must perform?
Ensure an accurate diagnosis, ensure excellent care (safe, effective, patient-centered, timely, effective, equitable), individualize patient care, improve community health, improve clinical performance.
What are patient management protocols?
Formally established expectations that define the normal steps or processes in the care of a clinically related group of patients at a specific institution. (e.g., diagnosing and treating chest pain at a specific facility)
What are functional protocols?
Procedures and sets of activities to carry out elements of care. (e.g., the process of prescribing medication)
Patient management protocols should be flexible and adaptable. What are some ways to do that?
Protocols should be reviewed regularly, they should emphasize conditional expectations, and they should include provisions for exceptions.
Patient management protocols improve:
Individual caregiver performance in four ways. 1. provides evidence-based guidelines. 2. Several professions can usee it to anticipate and coordinate care events. 3. Caregivers can use it as an outline to guide decisions 4. Measures performance and information collection.
Functional protocols improve:
Processes by: eliminating unnecessary tasks, looking for overlooked tasks, standardizing supplies, reducing errors, finding ways to lower costs, and re-engineering the care process
IOM Six dimensions of quality
Safety Timeliness Effectiveness Efficiency Equity Patient-centeredness
3 methods for process improvement
CQI, Lean, Six sigma
Donabedian’s definition of quality
Healthcare delivered using:
the right structure
the right processes
that produces good outcomes
What are clinical support services
Non-nursing, non-clinical services. Radiology clinical laboratory ED OR Pharmacy PT/OT cardio-respiratory therapy GI lab cardio diagnostics
Who manages the clinical services departments?
Each department has a manger that reports to the chief of patient care office, the COO, the CMO, or the VP of professional services.
Toughest job of the hospital:
Nursing manager of the OR
Who works in the OR
Anesthesia (MDA or CRNA) Surgical staff (Surgeon, PA/NP/SA, circulating nurse, surgical tech)
Pereoperative:
Pre, during, post
HCAHPS
Hospital Consumer Assessment of Healthcare Providers and Systems
Stoplight
Green - completed it
Yellow - working on it
Red - unable to be completed. Post it somewhere visible.
AIDET
Acknowledge, introduce yourself, Duration, Explanation, Thank
Studer execution framework
Align goals, behavior, and processes
Goals for high performers:
Re-recruit, recognize, retrain
Goals for middle performers
Reassure, re-recruit, develop
Goals for low performers
Improve or de-select
Barriers to change:
Denial, rationalization, blame, uniqueness, unwillingness, not skilled
Getting over the wall
You have to deselect low performers to get over the wall
Examples of social Determinants of Health
Health Care Education Housing Employment Income Food Access Transportation Physical and Built Environment Culture Literacy
WHO definition of health
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
Equity
“Fair opportunity for everyone to attain their full health potential regardless of demographic, social, economic or geographic strata.”
Triple aim of Health Equity
Implement health in all policies,
strengthen community capacity,
expand understanding of health
Social Determinants of Equity
Systems of power that determine the range of social contexts and the distribution of populations into those social contexts.
How often do you need to do a community health needs assessment?
Every 3 years
What is Community Benefit
Programs, services, and activities that non-profit health care organizations provide in response to community needs to improve community health or increase access to health care
How did the Clinic overhaul the patient experience?
Using in-system physician champions
(NPSGs)
National patient safety goals:
led by the Joint Commission to create a safer and more therapeutic environment for healthcare.
(PSO)
Patient Safety Organizations: collect, aggregate, and analyze reports of errors and near misses in a confidential database so that measures can be identified to promote safety.
IHI
Institute of Health Initiatives
ISMP
Institute of Safe Medical Practices
HIPAA
Health Insurance Portability and Accountability Act
OIG
Office of the Inspector General
CLIA
Clinical Laboratory Improvements Act. passed in response to several incidents in which Papanicolaou (pap) smears were misread or mixed up resulting in the misdiagnosis of many patients. Established minimum educational and experience requirements for all clinical laboratory personnel. Defined testing categories according to their level of complexity.
ALARA
As Low as Reasonably Achievable. measures should be taken to deliver the lowest level of exposure to radiation to the patient while still gaining the intended result.
