Nurs 4600 Midterm 1 – Questions With Verified
Solutions
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Terms in this set (123)
ex's of vulnerable groups -women & children
-persons of color
-immigrants
-gay pop.
-homeless
-mentally ill
-incarcerated,
-sub abuse
a collaborative process of assessment, case management
planning, facilitation, care coordination,
evaluation, and advocacy for options (right service at the right time= care coordination)
and services to meet an individual's and
family's comprehensive health needs
through communication and available
resources to promote quality, cost-
effective outcomes
-negotiates managed care systems IOT
(ideally) benefit pt first, then hospital
,system focused insurance strategy of managed care
managing care that attempts to manage
the COST of healthcare, quantity/quality
of that healthcare, and ACCESS to that
care, **economically driven...
-goal of this approach is to is to
encourage consumers, providers, and
payers to all *become accountable for
the use of limited and ever-expensive
healthcare resources
(Ex: needing to get a referral before
seeing a dermatologist)
goals & benefits of NCM (nursing case -provide quality healthcare
manag't)
-dec fragmentation via coordinating continuity of care
-^QOL (POSITIVE PT OUTCOMES & satisfaction)***
-contain costs
-dec LOS
historical events that lead to the -^chronic illness (^elderly pop)
creation of NCM - ^cost of healthcare d/t to no $ incentive to reduce
cost of services...lead to DRGs (created bundled
predetermined price tags per condition) aka change
from retrospective to prospective pay't
-^ in tech
-
, Any group that is Discriminated + vulnerable populations
Stigmatized + Politically disenfranchised
= Translates into lack of "social
connectedness = inequality in social
relationships with partners, employees,
gov't, service agencies etc"
individual that works in a collaborative certified case manager
practice that assesses, plans,
implements, coordinates, monitors, and
evals options/services required to meet
client s health and human service's
needs
how are the "focuses" different in case -CM is "pt focused", focuses on navigated care & ^ QOL
management vs. managed care
-managed care is "benefits focused", focuses on "cost
control"
model in which some total pt care primary nursing
concepts are used & brings RN to
bedside IOT provide clinical care, nurse
follows pt from admission to d/c
what specifically are vulnerable -premature death -complications
populations vulnerable to? -dec QOL
-inequality in social relationships w/ partners,
employees/gov't
brief timeline of CM from 1970s, 80s, 90s 70s: ^ healthcare costs
and now 80's: prospective payment system
90s: managed care becomes big
now: CM practiced in every setting across Healthcare
continuum
Solutions
Add to calendar
Play your way to mastery with fun games
Match Blocks Charms NEW
Terms in this set (123)
ex's of vulnerable groups -women & children
-persons of color
-immigrants
-gay pop.
-homeless
-mentally ill
-incarcerated,
-sub abuse
a collaborative process of assessment, case management
planning, facilitation, care coordination,
evaluation, and advocacy for options (right service at the right time= care coordination)
and services to meet an individual's and
family's comprehensive health needs
through communication and available
resources to promote quality, cost-
effective outcomes
-negotiates managed care systems IOT
(ideally) benefit pt first, then hospital
,system focused insurance strategy of managed care
managing care that attempts to manage
the COST of healthcare, quantity/quality
of that healthcare, and ACCESS to that
care, **economically driven...
-goal of this approach is to is to
encourage consumers, providers, and
payers to all *become accountable for
the use of limited and ever-expensive
healthcare resources
(Ex: needing to get a referral before
seeing a dermatologist)
goals & benefits of NCM (nursing case -provide quality healthcare
manag't)
-dec fragmentation via coordinating continuity of care
-^QOL (POSITIVE PT OUTCOMES & satisfaction)***
-contain costs
-dec LOS
historical events that lead to the -^chronic illness (^elderly pop)
creation of NCM - ^cost of healthcare d/t to no $ incentive to reduce
cost of services...lead to DRGs (created bundled
predetermined price tags per condition) aka change
from retrospective to prospective pay't
-^ in tech
-
, Any group that is Discriminated + vulnerable populations
Stigmatized + Politically disenfranchised
= Translates into lack of "social
connectedness = inequality in social
relationships with partners, employees,
gov't, service agencies etc"
individual that works in a collaborative certified case manager
practice that assesses, plans,
implements, coordinates, monitors, and
evals options/services required to meet
client s health and human service's
needs
how are the "focuses" different in case -CM is "pt focused", focuses on navigated care & ^ QOL
management vs. managed care
-managed care is "benefits focused", focuses on "cost
control"
model in which some total pt care primary nursing
concepts are used & brings RN to
bedside IOT provide clinical care, nurse
follows pt from admission to d/c
what specifically are vulnerable -premature death -complications
populations vulnerable to? -dec QOL
-inequality in social relationships w/ partners,
employees/gov't
brief timeline of CM from 1970s, 80s, 90s 70s: ^ healthcare costs
and now 80's: prospective payment system
90s: managed care becomes big
now: CM practiced in every setting across Healthcare
continuum
