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Module 7 > UNIT 4: Care Coordination > Flashcards

UNIT 4: Care Coordination Flashcards

1
Q

What is care coordination?

A

Care coordination is the “deliverate organization of patient care actvities between two or more participants involved in a patients care to facilitate the appropriate delivery of health care services”

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2
Q

Whose apart of care coordination?

A
  1. Hospital
  2. pharmacy
  3. physican office
  4. EMS
  5. Pallitative care
  6. Home Health
  7. Community support
  8. Long-term care
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3
Q

What are the roles of a case manager

A
  1. Coordinate patient care
  2. Schedules physical therapy, dialysis,
  3. Arranges for transfers to other facilities/transportation
  4. Arranges for hospice/pallative care
  5. Arrange for home health
  6. Arranges for medical equipment
  7. Arranges for home oxygen
  8. coding and billing for insurance
  9. Works with insurance for payment
  10. Assists with financial aid
  11. Arranges for home medical equipment

Goal is to avoid fragmentation of care

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4
Q

What kind of knowledge does a case manager need to have?

A

Must have advanced training and knowledge of surrounding area and be a resource for the patietns

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5
Q

What is the case management process?

A
  1. Screening
  2. Assessing
  3. stratifying risk
  4. planning
  5. implementing (care coordinateion)
  6. following up
  7. Transisitioning (transisitonal care)
  8. communication post transition
  9. evaluating
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6
Q

Medical mistakes are not due to error prone people but….

A

Poor processes.

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7
Q

What is quality improvement?

A
  1. Process of improving care and reducing deficiencies
  2. Meausres performance against standards
  3. Standards of care should reflect opitmal goals and be evidence-based
  4. JCAHO requires evidence for accreditation status

MUST HAVE A BUY IN OR IT DOESNT WORK>

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8
Q

CQI or continuous quality improvement (CQI) requires….

A
  1. Proactive approach to improvement of health care
  2. Emphasis on anticipating and preventing problems rather than reacting to them
  3. Requires close and constat scrutiny
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9
Q

Care should be…

A
  1. Safe: from injury
  2. Effective: Evidence based practice
  3. Partient-centered: pt wants to be a part of the plan we need to meet them where they are
  4. Equitable: Care doesnt change based on the money they have
  5. Efficient: Avoiding waste
  6. Timely: Wait times/delays- how long were you in the ed with the symptoms you had
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10
Q

What is hcahps?

A
  1. Hospital Consumer Assessment of Healthcare providers and systems
  2. Gives us a way to monitor the hospital.
  3. Not choosing to be apart of this doesnt allow us the funding nor the accredidation of being “elite”
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11
Q

What are the 8 measured items of hcahps

A
  1. Communcation with doctors
  2. Communication with nurses
  3. Responsiveness of hospital staff
  4. Pain managment
  5. Commication about meds
  6. discharge information
  7. cleanliness of environment
  8. Quietness of hospital environment
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12
Q

What is the process of developement of standards?

A
  1. Predetermined level of excellance that serves as a guide for practice
  2. Must be objective, measurable, and achievable
    • Outcome standards
    • Process standards
    • Structure standards
  3. Must meet established benchmark
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13
Q

Add more about slide 14

A
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14
Q

What is the QI process?

A
  1. Standards are determined
  2. Quality issues are identifed
  3. A team is developed to review the issue
  4. Current structure/process is analyzed
  5. Data is collected, analyzed and compared to benchmark
  6. If benchmark not met, possible influencing factors arfe determined
  7. Potential solutions or corrective actions are analyzed w/ 1 chosen
  8. Education of corrective action is implemented
  9. Issues is re-evaluated at pre established time
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15
Q

How can you improve quality?

A
  1. Serve on the policies and procedures commitee
  2. Use reliable sources for information
  3. be famililar with your facilitys p&ps
  4. Provide care consistent with P&Ps
  5. Document thoroughly and correctly
  6. Participate in review commitees
  7. Assist w/ education/traning necessary
  8. follow clinical practice guidelines
  9. act as a role model
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16
Q

Clinical practice guidelines…

A

Provide diagnosis-based step-by-step interventions for providers to follow to promote high quality care and control resource utilization

AKA standardized clinical guidelines
should reflect EBP

17
Q

What makes up the clinical practice guideline pyramid starting from the bottom?

A
  1. Background information/textbooks/expert opinion/manufacturer recommendation
  2. reviews
  3. case control studies/case reports/protocol
  4. Cohort studies/cross-sectional study/qualative studies
  5. Randomized control trials (RCT)
  6. Critical appraisal (topic/article)
  7. Meta-analysis systematic review/integrative review
  8. EBP guidelines
18
Q

What are audits?

A

Audits are routinely conducted to evaluate quality and aif standards are met

19
Q

What are outcome audits?

A
  1. Determine results of direct nursing care (no VAP infections for ex.)
20
Q

What is process audits?

A
  1. Review how care was provided (fall rates, catis)
21
Q

What are structure audits?

A

Evaluate interactions outside of patient staff interactions (documenting)

22
Q

What are common issues in healthcare?

A
  1. Patient discharge delays
  2. Care variation: When we dont follow standards..this is why we have protocol
  3. Avoidable medical errors: Tired nurses make more efforts. Double check each other. Ask question
  4. Communication breakdowns between providers (provider and lab, provider and nurse)
23
Q

What are examples of high quality instituations?

MUST KNOW

A
  1. The leapfrog group
  2. ANCC magnet- list of things we need to do.
  3. Hospital quality initative: centers for medicare and medicaid services
  4. Core Measures: The joint commision

These measure the quality gap which is the difference in proformance between the top performing hospital and the national average.

24
Q

What is risk managment?

A
  1. Component of QI management
  2. Focuses on identifying, analyzing and evaluating risks
  3. Overall goal is to reduce risk to decrease harm to patients
  4. Incident reports used to track and analyze events (root cause analysis)
25
Q

What is a root cause analysis?

A
  1. Tracks events leading to error, identifies faulty systms and processes and develops a plan to prevent further errors.
  2. Get to the root of why
  3. JCOHO sets mandatory national patient safety goals to address selected risks
  4. Overall goal is to promote quality evidence based measures to maximize health benifits
26
Q
A
27
Q

National patient safety goals?

A
  1. Identify pt correctly
  2. Improve staff communication
  3. Use medicene safely
    • PINCH drugs: potassium, insulin, narcotics, and sedative agents, chemo, heparin
    • Star alert: Stop think act and review look alike drugs
  4. Use alarms safely
  5. Prevent infection
    • VAP, CATI, Handwashing, PPE
  6. Idenfiy safety risks
    • Every pt is screen for sucide
  7. Prevent surgical mistakes
    • Time outs/markings put into place, concents
28
Q

What are the four main categories/steps to risk managment?

A
  1. Risk identification
  2. Risk analysis
  3. Risk treatment
  4. Risk evaluation
29
Q

What are high risk areas in the hospital in terms of risk managment?

A
  1. Med errors
  2. Refusal of tx
  3. Complications from tests/treatments
  4. Refusal to sign concents
  5. falls
  6. Patient/family dissatification
30
Q

What is a sentinel event?

A

As defined by the joint commision as any unanticipated event in a health care setting resulting in death or serious physical or psychological injury to a patient or patients not related to the natural course of the patients illness, or the risk there of

AKA: results in dealth, permanent harm (wrong amputation), severe/temporary harm that requires life sustaining intervention

31
Q

What are some examples of sentinenal events

A
  1. infant abduction, or discharge to the wrong family
  2. Unexpected death of a full-term infant
  3. Severe neonatal jaundice
  4. Fall
  5. Surgery on the wrong individual or wrong body part or object left in patinet
  6. rape in the acute care setting
  7. Suicide in an acute-care setting or within 72 hours of discharge
  8. hemolytic transfusion reactions due to blood group incompatibilites
  9. Fire
  10. Rad tx
32
Q
A

Module 7 (22 decks)

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