WGU D046 Questions With 100% Correct Answers Latest Updated 2023/2024 | Verified

Determine length of stay, average cost the hospital should charge for similar patients. PCMH-patient centered medical home HUB/WHEEL coordinated through primary care physician to make sure patients recieve care they need. partnership between patients and their personal healthcare team. centralized "neighborhood" of communtiy resources. AIMS Model Patient engagement Assessment and care plan development Case management Ongoing care as needed PACO LIKE TACO Primary care coordination in the guided care model, a specially educated RN is responisble for patients with multiple chronic conditions. coordinates specially with other providers to ensure nothing is missed. Accute care coordination accute health problems (heart attack/stroke) require complex level of care becuae of critical emergency nature. risk for communication breakdowns, redundancies and medical errors can increase with diffrent providers involved. continues when emergency has passed. scheduling follow up visits, making sure meds filled, reviewing follow up instructions. goal is to reduce hospital readmission rates, prevent avoidable er visits Tripple Aim/Quadruple Aim Improve patient outcoms Improve patient experience Lower cost of care for patient. QA-Improve phyisican experiance. added to prevent burnout Post accute long term care coordination Rehab, long term care (LTC), post accute care PAC facilities may need to move between facilities or diffrent levels within same facilities. predominatly senior aged. readmission risk factors may signify inadequate transitional care process or a mismatch between patients needs and PAC resources Population Health Health outcomes and efforts to influence these outcomes of a group of individuals key-pop with a similar characteristic.(age, geographic proximity, similar diagnoses) Clinical case management model (counselor/therapist) clinical care provider serves as case manager. provides direct counseling for a clients individual needs. encourages the client to connect with informal resources such as family, friends and peers. Strengths based case management model focuses on empowering clients and their families growth, education, and skill development. recognizes value of community services encourages client to take lead in identifiying their own needs. involves outreach, clinical services, advocacy. clinical community linkages Helps connect HCP, community organizations to improve patients access to preventative and chronic care services. patients get more help in changing unhealthy behaviors. clinicians get help in offering services to patients that they cannot provide themselves community programs get help in connecting with client for whom their services were designed. AIMS Patient engagement phase PACO Interact with the patient and their family, ensure that their questions are answered, and to provide guidance and resources that will help navigate patients through their care plan Validating a patient's concerns Reinforcing the role of the coordinator as a helper/resource Giving information to address immediate concerns AIMS Assesment PACO Allow the coordinator to "identify social and environmental factors that may affect medical plan adherence, health care services utilization, and health care outcomes. The assessment process collects information that is helpful for interpreting the completed assessment and using that information to develop a comprehensive care plan that will address the patient's medical and non-medical challenges. AIMS Case Management Phase PACO is all about ensuring that the patient stays on track and has the support and he/she needs. Under this model, case management includes