NURS 372: Final Exam Review (Old Content)
The triple aim was created by what organization?
Institute for Healthcare Improvement (IHI)
The three deminsions of triple aim and its focus
- quality
- safety
- innovation
What is a population?
collection of people who share one or more personal or environmental
characteristics
-registry tracking a defined group of people over time
Dimension 1: Improving population health
the health outcomes of a group of individuals including the distribution of such
outcomes within the group
Dimension 2: Improve the patient care experience
- The perspective of the individual as he or she interacts with the healthcare
system
- The perspective of the healthcare system focused on designing a high quality
experience for patients.
Dimension 3: Reducing Per Capita Healthcare Costs
by saving money that's wasted in healthcare every day we could:
improve health care quality and improve health of populations
There are multiple types of aims we can use but we use which one?
Triple aim- because we can barely get these 3 things right...why add more
add more if you can but focus on the 3 dimensions first!
Why do we care?
US healthcare is expensive
There are new demands on medical and social services related to:
Aging population
Increased longevity
Chronic conditions
,How do we make this happen?
o "Upstream Approach"
o There are more factors in play with our patients than just seeking and getting
the healthcare they need
o Making smarter decisions based on long term thinking
o Fixing the heart of problems, not just putting a band-aid on it
Social determinants of health
Non-medical factors which influence health outcomes. These factors include the
conditions in which people are born, grow, work, live, and age (CDC, 2022).
Health equity
The state in which everyone has the opportunity to attain their full health
potential and is not disadvantaged because of social position or other socially
determined circumstances (CDC, 2020).
Health literacy
The degree to which individuals have the ability to find, understand, and use
information and services to inform health-related decisions and actions for
themselves (CDC, 2023).
Health disparity
Preventable differences in the burden of disease, injury, violence, or
opportunities to achieve optimal health that are experienced by socially
disadvantaged populations (CDC, 2023).
Aspects of the Social Determinants of Health (SDOH)
People with more money the less likely they will have any...
stress, health problems, etc.
Examples of SDOH
Quadruple Aim in healthcare
adds care team well being
Quintuple Aim in Healthcare
Health equity affects:
· Length of life
· Quality of life
· Rates of disease, disability, and death
· Severity of disease
,· Access to treatment
-Racial and ethnic minority groups are often disproportionately affected by health
inequities.
What are a few reasons why a person might not go to the doctor?
can't afford- NO INSURANCE!
don't trust/like doctor
scheduling conflicts
afraid of outcome
language barriers
transportation
Health literacy definition
the degree to which individuals have the capacity to obtain, process, and
understand basic health information and services needed to make appropriate
health decisions
Clinical Decision Support System
- intended to improve healthcare delivery by enhancing medical decisions with
targeted clinical knowledge, patient info, and other health info
- comprised of software designed to be a direct aid to clinical decision-making, in
which the characteristics of an individual pt are matched to a computerized
clinical knowledge base and pt-specific assessments or recommendations are
then presented to the clinical for a decision
Where CDSSs are Used
- primarily used at the point-of-care, for the clinician to combine their knowledge
with information or suggestions provided by the CDSS
Administration of CDSSs
- often make use of web-applications or integration with EHRs and computerized
provider order entry systems
- can be administered through desktop, tablet, smartphone, biometric monitoring,
wearable health technology
Classification of CDSSs
- knowledge-based or non-knowledge based
Knowledge Based CDSSs
- rules (if-then statements) are created
- system retrieves data to evaluate the rule and produces an action/output
, - rules can be made using literature-based, practice-based or patient-directed
evidence
Non Knowledge Based CDSSs
- still require a data source, but the decision leverages AI, machine learning, or
statistical pattern recognition rather than being programmed to follow expert
medical knowledge
Difference Between Knowledge and Non Knowledge Based CDSSs
- knowledge based uses an interface engine and bases its findings on expert
medical knowledge whereas non knowledge based uses an AI powered interface
engine to produce an algorithm/pattern rather than expert knowledge
Rules in Knowledge Based CDSSs
- based on literature, practice, or patient-directed evidence
Scope of Functions in CDS
- diagnostics, alarm systems, disease management, prescription drug control,
etc.
- can manifest as computerized alerts and reminders, computerized guidelines,
order sets, pt data reports, documentation templates, and clinical workflow tools
Advantages of CDS
- pt safety
- clinical management
- cost containment
- administrative function/automation
- diagnostic support
- support with imaging, lab, and pathology
- pt decision support
- better documentation
- workflow improvement
Patient Safety Advantage
- reduces incidence of med/prescribing errors and adverse events
Clinical Management Advantage
- promotes adherence to clinical guidelines, follow-up and treatment reminders,
etc.
Administrative Function/Automation Advantage
- diagnostic code selection, automated documentation and note autofill
The triple aim was created by what organization?
Institute for Healthcare Improvement (IHI)
The three deminsions of triple aim and its focus
- quality
- safety
- innovation
What is a population?
collection of people who share one or more personal or environmental
characteristics
-registry tracking a defined group of people over time
Dimension 1: Improving population health
the health outcomes of a group of individuals including the distribution of such
outcomes within the group
Dimension 2: Improve the patient care experience
- The perspective of the individual as he or she interacts with the healthcare
system
- The perspective of the healthcare system focused on designing a high quality
experience for patients.
Dimension 3: Reducing Per Capita Healthcare Costs
by saving money that's wasted in healthcare every day we could:
improve health care quality and improve health of populations
There are multiple types of aims we can use but we use which one?
Triple aim- because we can barely get these 3 things right...why add more
add more if you can but focus on the 3 dimensions first!
Why do we care?
US healthcare is expensive
There are new demands on medical and social services related to:
Aging population
Increased longevity
Chronic conditions
,How do we make this happen?
o "Upstream Approach"
o There are more factors in play with our patients than just seeking and getting
the healthcare they need
o Making smarter decisions based on long term thinking
o Fixing the heart of problems, not just putting a band-aid on it
Social determinants of health
Non-medical factors which influence health outcomes. These factors include the
conditions in which people are born, grow, work, live, and age (CDC, 2022).
Health equity
The state in which everyone has the opportunity to attain their full health
potential and is not disadvantaged because of social position or other socially
determined circumstances (CDC, 2020).
Health literacy
The degree to which individuals have the ability to find, understand, and use
information and services to inform health-related decisions and actions for
themselves (CDC, 2023).
Health disparity
Preventable differences in the burden of disease, injury, violence, or
opportunities to achieve optimal health that are experienced by socially
disadvantaged populations (CDC, 2023).
Aspects of the Social Determinants of Health (SDOH)
People with more money the less likely they will have any...
stress, health problems, etc.
Examples of SDOH
Quadruple Aim in healthcare
adds care team well being
Quintuple Aim in Healthcare
Health equity affects:
· Length of life
· Quality of life
· Rates of disease, disability, and death
· Severity of disease
,· Access to treatment
-Racial and ethnic minority groups are often disproportionately affected by health
inequities.
What are a few reasons why a person might not go to the doctor?
can't afford- NO INSURANCE!
don't trust/like doctor
scheduling conflicts
afraid of outcome
language barriers
transportation
Health literacy definition
the degree to which individuals have the capacity to obtain, process, and
understand basic health information and services needed to make appropriate
health decisions
Clinical Decision Support System
- intended to improve healthcare delivery by enhancing medical decisions with
targeted clinical knowledge, patient info, and other health info
- comprised of software designed to be a direct aid to clinical decision-making, in
which the characteristics of an individual pt are matched to a computerized
clinical knowledge base and pt-specific assessments or recommendations are
then presented to the clinical for a decision
Where CDSSs are Used
- primarily used at the point-of-care, for the clinician to combine their knowledge
with information or suggestions provided by the CDSS
Administration of CDSSs
- often make use of web-applications or integration with EHRs and computerized
provider order entry systems
- can be administered through desktop, tablet, smartphone, biometric monitoring,
wearable health technology
Classification of CDSSs
- knowledge-based or non-knowledge based
Knowledge Based CDSSs
- rules (if-then statements) are created
- system retrieves data to evaluate the rule and produces an action/output
, - rules can be made using literature-based, practice-based or patient-directed
evidence
Non Knowledge Based CDSSs
- still require a data source, but the decision leverages AI, machine learning, or
statistical pattern recognition rather than being programmed to follow expert
medical knowledge
Difference Between Knowledge and Non Knowledge Based CDSSs
- knowledge based uses an interface engine and bases its findings on expert
medical knowledge whereas non knowledge based uses an AI powered interface
engine to produce an algorithm/pattern rather than expert knowledge
Rules in Knowledge Based CDSSs
- based on literature, practice, or patient-directed evidence
Scope of Functions in CDS
- diagnostics, alarm systems, disease management, prescription drug control,
etc.
- can manifest as computerized alerts and reminders, computerized guidelines,
order sets, pt data reports, documentation templates, and clinical workflow tools
Advantages of CDS
- pt safety
- clinical management
- cost containment
- administrative function/automation
- diagnostic support
- support with imaging, lab, and pathology
- pt decision support
- better documentation
- workflow improvement
Patient Safety Advantage
- reduces incidence of med/prescribing errors and adverse events
Clinical Management Advantage
- promotes adherence to clinical guidelines, follow-up and treatment reminders,
etc.
Administrative Function/Automation Advantage
- diagnostic code selection, automated documentation and note autofill
