Week 5 + Week 6 Flashcards
Egalitarian theory
Everyone is equal and deserves equal rights
Utilitarian theory
The right thing benefits the greater good.
- looks at outcomes
Libertarian theory
A political theory that focuses on liberty
- will say that masking takes away people’s liberty, thus is wrong.
Communitarian theory
Communitarian = Philosophy that says deep connection b/w person & community.
- Eastern cultures focus on community & not on promoting individualism
What are the 5 principles of the Canada Health Act?
1) Universality - everyone deserves healthcare
2) Comprehensiveness - covers necessary medical procedures/tests
3) Accessibility - free of barriers (cost)
4) Portability - Nationwide access to healthcare
5) public administration - public oversight
Who is uninsured for healthcare in Ontario?
- New immigrants (less than 3 months residency)
- violations of work visa
- overstaying work visa
- homeless —> no health card
- temporary migrant workers that move residences or change employers;
What is the Beveridge model on healthcare
Health care is provided & financed by the government through tax payments rather than insurance based.
- Most hospitals & clinics are owned by the government (‘single player model’)
- Lower costs per capita because the Government controls what doctors can charge (single payer)
- Physician is the gate keeper to health care
- Focus on Primary Care
- Great Britain, Spain, Scandinavia, New Zealand
What is the Bismarck Model on healthcare?
- Uses an insurance system – “sickness funds”
- Financed jointly by employee/employer through payroll deductions
- Insurance plans cover everyone
- Multi-payer model / non-profit (unlike US)
- Doctors & hospitals private
- Tight regulation gives the government much of the cost-control power (Single payer like Beveridge)
- Germany, France, Belgium, the Netherlands, Japan, Switzerland, Latin America
What is The National Health Insurance Model?
- Single-payer systems
- Elements of both Beveridge & Bismarck
- The single-payer systems have more market power to negotiate for lower prices
- Simple administration
- Uses private-sector providers, but payment comes from a government-run insurance program that every citizen pays into (non-profit)
- Control costs by limiting medical services they will pay for, or by making patients wait to be treated
- Canada, Taiwan & South Korea
What is The Out-of-Pocket Model?
- “Plan” used by most nations which are too poor/disorganized to provide any mass medical care
In these poor countries, only the rich can afford medical care
In rural regions of Africa, India, China & South America, hundreds of millions of people go their whole lives without ever seeing a doctor
Rely on ‘village healers’ & home remedies
May pay a doctor’s bill with potatoes or other produce
What is the healthcare model of the U.S.?
- Elements of all models – “fragmented”
Working Americans who get insurance on the job: Bismarck System
Veterans: similar to the Beveridge system
Americans over age of 65 who have been legal residents of the US for at least 5 years: National Health Insurance
15 % of the population have no health insurance:
Out-of-pocket
Where does Canada’s funding for healthcare come from?
The federal government uses the revenue to provide a block grant to the provinces (finances 16% of healthcare)
The remainder is funded by provincial taxes (personal & corporate income taxes)
What are the responsibilities of the Ontario Health Agency?
System management & performance
- planning & delivering health care, improving the quality of care
measuring & managing how the system performs
enabling innovation, ensuring financial accountability, providing clinical leadership
Population-based programs & clinical & quality standards
- overseeing highly specialized care (for example, cancer, organ donation)
- managing provincial population health programs (for example, cancer screening)
- overseeing critical care
- investigating & supporting new & emerging health services
- developing evidence-based advice for delivering health services & clinical care
Back-office support
- managing supply-chains
System oversight
- assessing & planning for local needs; holding accountability for Ontario Health Teams
What are the 3 attributes of collaboration?
1) sharing
2) teamwork
3) respect
What is the criteria for interprofessional collaboration?
- understand each others’ roles
- trusting each other
- valuing each role
- losing the hierarchies
- seeking a common goal
- sharing skills and knowledge
- working together to address problems
- supporting each other when mistakes are made
- ## celebrate achievements made
What are the 6 frameworks as outlined by Canadian Interprofessional Health Collaboration (CIHC)?
1) Role clarification
2) Team functioning
3) Interprofessional communication (ISBAR, close-loop)
4) Patient/family/community-centered care
5) Interprofessional conflict resolution
6) Collaborative leadership
What is the goal of interprofessional collaboration?
To provide holistic care
Is it okay to accept a delegate from someone and then delegate that same thing to someone else?
No
Which controlled acts can RNs delegate?
- Performing a prescribed procedure below the dermis or mucous membrane;
- Administering a substance by injection or inhalation
- Putting an instrument, hand or finger beyond/into the 7 documented areas of the body
What are the client factors in the 3-factor framework?
Client factors:
- Acuity of care needs
- predictability of outcomes
- the risk of negative outcomes
The more complex, unpredictable, and higher risk for negative outcomes ==> greater need for more qualified, advanced nurses
What are the nurse factors in the 3-factor framework?
● Is the nurse a novice, advanced beginner, proficient, or expert?
● Is an advanced competency required?
What are the environmental factors in the 3-factor framework?
Environment factors include:
- practice supports,
- consultation resources
- stability/predictability of the environment
The less stable these factors are, the greater the
need for RN staffing and interprofessional collaboration.
Under what circumstances is it okay to delegate to unregulated nursing personnel?
The procedure must have been established over time & outcomes must be predictable
- ex. toileting and bathing; does not require delegation
