Healthcare Delivery Systems
> social determinants of health (SDOH) > press ganey
• economic stability, physical environment, • measure healthcare delivery, client
education, food, social context, health care satisfaction
system • emailed to client after visit
>
-
care levels
>
- sentinel event - never event
• primary - family practice physicians, NP, midwives
• results in dealth or permanent/severe
- common problems (sore throat, vaccines) family temporary pain
planning, screenings, medications
• reported to TJC, tracked to improve safety
• secondary - speciality physicians peds, neurology, time out
APN
• prevents wrong site surgery
- hospital care for MI, stroke, disease
identification/management • confirm patient, procedure
>
ISBARR
• tertiary - subspecialist physicians cardio surgeons,
APN • intro
- management of complex disorders, congenital • situation - reason for contact, diagnosis,
malformations, pituitary tumors changing conditions
>
- assisted living vs skilled nursing facility • background - brief history of factors to
• AL - assistance with ADLs, social activities, current situation
apartment-style • assessment - vitals, physical, mental state
- for active social older adults • recommendation - suggestions for actions,
explanation of what is needed
• SNF - extensive, 24hr medical care, meal
assistance, increased safety, private/shared • readback - verify direction and confirm
rooms orders
- increased level of care, monitoring, assistance
medicare vs. medicaid
- medicare - 60 plus, disability
B medicaid - indivudal/family with limited income and
resources
>
- resource utlization groups (RUGs)
• in long-term care setting, reimbursement based
on clients DRG
↳
• DRG - when admitted coded into based on primary
diagnosis, age, sex
- recieve fized cost based on DRG
> hospital readmissions reduction program (HRRP)
• bsck within 30 days of treatment, hospital not
reimbursed
• AMI, COPD, HF, CABG
- The Joint Commision (TJC)
• nonprofit, accredits health care orgs
>
- magnet recognition
- better client quality indicators: lower fall rates,
improved skin integrity, client communication
- hospital consumer assessment of healthcare providers
and systems (HCAHPS)
• randomly to clients 48 hrs to 6 weeks after visit
• standardized questions, publically recorder
> social determinants of health (SDOH) > press ganey
• economic stability, physical environment, • measure healthcare delivery, client
education, food, social context, health care satisfaction
system • emailed to client after visit
>
-
care levels
>
- sentinel event - never event
• primary - family practice physicians, NP, midwives
• results in dealth or permanent/severe
- common problems (sore throat, vaccines) family temporary pain
planning, screenings, medications
• reported to TJC, tracked to improve safety
• secondary - speciality physicians peds, neurology, time out
APN
• prevents wrong site surgery
- hospital care for MI, stroke, disease
identification/management • confirm patient, procedure
>
ISBARR
• tertiary - subspecialist physicians cardio surgeons,
APN • intro
- management of complex disorders, congenital • situation - reason for contact, diagnosis,
malformations, pituitary tumors changing conditions
>
- assisted living vs skilled nursing facility • background - brief history of factors to
• AL - assistance with ADLs, social activities, current situation
apartment-style • assessment - vitals, physical, mental state
- for active social older adults • recommendation - suggestions for actions,
explanation of what is needed
• SNF - extensive, 24hr medical care, meal
assistance, increased safety, private/shared • readback - verify direction and confirm
rooms orders
- increased level of care, monitoring, assistance
medicare vs. medicaid
- medicare - 60 plus, disability
B medicaid - indivudal/family with limited income and
resources
>
- resource utlization groups (RUGs)
• in long-term care setting, reimbursement based
on clients DRG
↳
• DRG - when admitted coded into based on primary
diagnosis, age, sex
- recieve fized cost based on DRG
> hospital readmissions reduction program (HRRP)
• bsck within 30 days of treatment, hospital not
reimbursed
• AMI, COPD, HF, CABG
- The Joint Commision (TJC)
• nonprofit, accredits health care orgs
>
- magnet recognition
- better client quality indicators: lower fall rates,
improved skin integrity, client communication
- hospital consumer assessment of healthcare providers
and systems (HCAHPS)
• randomly to clients 48 hrs to 6 weeks after visit
• standardized questions, publically recorder
