Nurs 4600 Midterm 1 Test With
Solution
-women & children
-persons of color
-immigrants
-gay pop.
-homeless
-mentally ill
-incarcerated,
-sub abuse - ANSWER ex's of vulnerable groups
case management
(right service at the right time= care coordination) - ANSWER a collaborative
process of assessment, planning, facilitation, care coordination, evaluation,
and advocacy for options 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
,managed care - ANSWER system focused insurance strategy of 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)
-provide quality healthcare
-dec fragmentation via coordinating continuity of care
-^QOL (POSITIVE PT OUTCOMES & satisfaction)***
-contain costs
-dec LOS - ANSWER goals & benefits of NCM (nursing case manag't)
-^chronic illness (^elderly pop)
, - ^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
- - ANSWER historical events that lead to the creation of NCM
vulnerable populations - ANSWER Any group that is Discriminated +
Stigmatized + Politically disenfranchised = Translates into lack of "social
connectedness = inequality in social relationships with partners, employees,
gov't, service agencies etc"
certified case manager - ANSWER individual that works in a collaborative
practice that assesses, plans, implements, coordinates, monitors, and evals
options/services required to meet client s health and human service's needs
-CM is "pt focused", focuses on navigated care & ^ QOL
-managed care is "benefits focused", focuses on "cost control" - ANSWER
how are the "focuses" different in case management vs. managed care
primary nursing - ANSWER model in which some total pt care concepts are
used & brings RN to bedside IOT provide clinical care, nurse follows pt from
admission to d/c
Solution
-women & children
-persons of color
-immigrants
-gay pop.
-homeless
-mentally ill
-incarcerated,
-sub abuse - ANSWER ex's of vulnerable groups
case management
(right service at the right time= care coordination) - ANSWER a collaborative
process of assessment, planning, facilitation, care coordination, evaluation,
and advocacy for options 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
,managed care - ANSWER system focused insurance strategy of 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)
-provide quality healthcare
-dec fragmentation via coordinating continuity of care
-^QOL (POSITIVE PT OUTCOMES & satisfaction)***
-contain costs
-dec LOS - ANSWER goals & benefits of NCM (nursing case manag't)
-^chronic illness (^elderly pop)
, - ^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
- - ANSWER historical events that lead to the creation of NCM
vulnerable populations - ANSWER Any group that is Discriminated +
Stigmatized + Politically disenfranchised = Translates into lack of "social
connectedness = inequality in social relationships with partners, employees,
gov't, service agencies etc"
certified case manager - ANSWER individual that works in a collaborative
practice that assesses, plans, implements, coordinates, monitors, and evals
options/services required to meet client s health and human service's needs
-CM is "pt focused", focuses on navigated care & ^ QOL
-managed care is "benefits focused", focuses on "cost control" - ANSWER
how are the "focuses" different in case management vs. managed care
primary nursing - ANSWER model in which some total pt care concepts are
used & brings RN to bedside IOT provide clinical care, nurse follows pt from
admission to d/c
