primary objectives of a healthcare delivery system - ✔️✔️-to enable all citizens to
receive healthcare services whenever needed - universal access
-to deliver services that are cost-effective and meet certain pre-established standards of
quality
The Joint Commission - ✔️✔️a not-for-profit organization that evaluates and accredits
different types of healthcare facilities.
· Predominant standards-setting
· Accrediting body in health care.
· Support performance improvement
· Team of Surveyors
· Voluntary Accreditation...
· Required for some third-party reimbursements
The Joint Commission National Patient Safety Goals - ✔️✔️· Improve the accuracy of
patient ID
· Improve effectiveness of communication among caregivers
· Improve safety of medication use
· Reduce risk of healthcare-associated infections
· Accurately and completely reconcile medications across the continuum of care
5 parts of PPACA - ✔️✔️1: provide coverage for the underserved
2: includes "guaranteed issue" for everyone, regardless of any preexisting condition or
health status
3: includes "individual mandate", which requires any American under the age of 65 to
purchase insurance, however making sure that Medicaid was still available to those
Americans who needed it.
4: financing the added expense of the act
5:
How to obtain health insurance - ✔️✔️through government programs as Medicare or
Medicaid, through employer, or through private insurance company
Pay for Performance (P4P) - ✔️✔️performance-oriented incentives for hospitals and
physicians to improve the quality of patient healthcare
never events - ✔️✔️Serious but preventable errors that should never occur, and
insurance will not pay for
, Value-based purchasing (VBP) - ✔️✔️*CMS (Centers for Medicare & Medicaid
Services) reimbursement rewards hospitals for providing quality care to include patient
satisfaction.
types of care - ✔️✔️primary, secondary, tertiary
describe primary care - ✔️✔️first contact with the Health Care Delivery System
focuses on person/population, education, and prevention
describe secondary care - ✔️✔️Dx & Tx of illness: Focus on acute health problems &
diseases
describe tertiary care - ✔️✔️Patient care in a specialized medical facility
cost shifting - ✔️✔️Providers basically raise prices on insured people and public and
private insurers in order to compensate for people who can't pay
Patient Centered Care - ✔️✔️providing care that is respectful of and responsive to
individual pt. preferences, needs and values and ensuring that pt. values guide all
clinical decisions
Factors in lack of access to healthcare - ✔️✔️-geographic area-financial/insurance
-lack of PCP
-Transportation
-out of pocket expense
-lack of education
Insitute of Medicine (IOM) - ✔️✔️Ensure that nurses engage in lifelong learning.
Quality and Safety Education for Nurses (QSEN) - ✔️✔️Prepare nurses to have the
knowledge, skills and attitudes necessary to continuously improve the quality and safety
of the HC system
American Nurse Association (ANA) - ✔️✔️Professional organization that represents all
registered nurses
Teamwork and Collaboration - ✔️✔️Function effectively within nursing and inter-
professional teams, fostering open communication, mutual respect, and shared
decision-making to achieve quality patient care.
Evidence-based Practice (EBP) - ✔️✔️Integrate best current evidence with Clinical
expertise. Patient/family preferences and values. For delivery of optimal health care