Quality and Performance Improvement in Healthcare Chapter 1 EXAM with 100% correct answers

Accountable Care Organization (ACO) a network of doctors and hospitals that shares responsibility for managing the quality and cost of care provided to a group of patients Affordable Care Act of 2010 Legislation that focuses on providing or improving access to healthcare services for millions of US citizens, including new restrictions on the ability of payers to limit coverage on the basis of preexisting conditions, an end to lifetime limits on coverage, and a requirement for payers to spend premium dollars on healthcare costs and not administrative costs Cost The amount of financial resources consumed in the provision of healthcare services. Outcome The results of care, treatment, & services in terms of the patient's expectations, needs, and quality of life, which may be positive and appropriate or negative and diminishing Performance Improvement The continuous & adaptation of a healthcare organization's functions & processes to increase the likelihood of achieving the desired outcomes. Process The interrelated activities of healthcare organizations-including governance, managerial support, and clinical services-that affect patient outcomes across departments and disciplines within integrated environment Quality Degree or grade of excellence of goods or services, including, in healthcare, meeting expectations for outcomes of care. Quality Assurance Audit activities designed to measure the quality of services, products, or processes followed by remedial action to improve care delivery Retrospective Payment System A type of fee-for-service payment in which healthcare providers are paid for services provided to patients in the past. Structure The foundation of caregiving, which includes buildings, equipment, technology, professional staff, and appropriate policies. Total Quality Management Management theory that mobilizes individuals directly involved in a work process to examine and improve the process with the goal of achieving a better product or outcome. Value Based Purchasing A system in which purchasers hold providers of healthcare accountable for both the costs of healthcare and its quality Summarize the historical events that have contributed to modern performance improvement programs 1700s Mid 1700s—Pennsylvania Hospital becomes the model for the organization and development of hospitals. 1760—New York State begins the practice of medical licensure. 1771- New Jersey begins the practice of medical licensure. 1800s 1837—Massachusetts General Hospital sets limitations on clinical practice in the first granting of clinical privileges • 1853—Massachusetts General establishes the first disease and procedure index by classifying patient disposition • Mid-1800s—Medical licensure is deemed undemocratic and is stopped • 1872—New England Hospital for Women and Children organizes a general training school for nurses. 1874—AMA encourages the creation of independent state licensing boards. 1900s 1903 North Carolina passes the first nurses registration bill in the U.S 1910 Flexner Report- indicates unacceptable variation in medical school cirricula. 1917- ACS establishes the Hospital Standardization Program. 1920 Most colleges meet rigorous academic standards and are approved by the Association of American Medical Colleges. 1946 - HillBurton Act established funding to build new hospitals. 1952 Joint Commission of Accreditation of hospitals were formed. 1965 Public Law 89-97 established MC & MK. 1972 Local peer review organizations are formed. 1980s PPS is established, state and regional peer review organizations contract w/ HCFA. 1990s JCAHO integrates quality improvement into the accreditation process. 2000s 2001 Ambulatory payment classification system is initated. 2002 HCFA becomes MC & MK Services ( CMS). 2003 JCAHO implements the National Patient Safety Goals. 2005 JCAHO begins unannounced and tracer methodology surv eys. 2007 JCAHO renames itself The Joint Commission 2008 Medicare Severity DRGs are implemented 2009 HITECH legislation is passed. 2010 Affordable Care Act is passed 2015 IC Early Quality and Performance Improvements in Healthcare Healthcare Institutions Medical practice Nursing practice Allied health professionals