TEST BANK FOR PRIMARY CARE, A COLLABORATIVE PRACTICE, 6TH EDITION BUTTARO

Which assessments of care providers are performed as part of the Value Based Purchasinginitiative? Select all that apply. a. Appraising costs per case of care for Medicare patients b. Assessing patients’ satisfaction with hospital care c. Evaluating available evidence to guide clinical care guidelines d. Monitoring mortality rates of all patients with pneumonia e. Requiring advanced IT standards and minimum cash reserves ANS: A, B, D Value Based Purchasing looks at five domain areas of processes of care, including efficiency of care (cost per case), experience of care (patient satisfaction measures), and outcomes of care (mortality rates for certain conditions. Evaluation of evidence to guide clinical care is part of evidence-based practice. The requirements for IT standards and financial status are part of Accountable Care Organization standards. REF: Value Based Purchasing Buttaro: Primary Care, A Collaborative Practice, 2. What was an important finding of the Advisory Board survey of 2014 about primary carepreferences of patients? a. Associations with area hospitals b. Costs of ambulatory care c. Ease of access to care d. The ratio of providers to patients ANS: C As part of the 2014 survey, the Advisory Board learned that patients desired 24/7 access to care, walk-in settings and the ability to be seen within 30 minutes, and care that is close to home. Associations with hospitals, costs of care, and the ratio of providers to patients were not part of these results. REF: The New Look of Primary Care 3. A small, rural hospital is part of an Accountable Care Organization (ACO) and is designatedas a Level 1 ACO. What is part of this designation? a. Bonuses based on achievement of benchmarks Test Bank 2 b. Care coordination for chronic diseases c. Standards for minimum cash reserves d. Strict requirements for financial reporting ANS: A A Level 1 ACO has the least amount of financial risk and requirements, but receives shared savings bonuses based on achievement of benchmarks for quality measures and expenditures. Care coordination and minimum cash reserves standards are part of Level 2 ACO requirements. Level 3 ACOs have strict requirements for financial reporting. REF: Accountable Care Organizations Buttaro: Primary Care, A Collaborative Practice, Chapter 2: Transitional Care Test Bank Multiple Choice 1. To reduce adverse events associated with care transitions, the Centers for Medicare andMedicaid Service have implemented which policy? a. Mandates for communication among primary caregivers and hospitalists b. Penalties for failure to perform medication reconciliations attime of discharge c. Reduction of payments for patients readmitted within 30 days after discharge d. Requirements for written discharge instructions for patients and caregivers ANS: C As a component of the Affordable Care Act, the Centers for Medicare and Medicaid Service developed the Readmissions Reduction Program reducing payments for certain patients readmitted within 30 days of discharge. The CMS did not mandate communication, institute penalties for failure to perform medication reconciliations, or require written discharge instructions. REF: Transitional Care 2. According to Naylor’s transitional care model, which intervention has resulted in lower costsand fewer rehospitalizations in high-risk older patients? a. Coordination of post-hospital care by advanced practice nurses b. Frequent post-hospital clinic visits with a primary care provider c. Inclusion of extended family members in the outpatient plan of care d. Telephone follow up by the pharmacist to assess medication compliance ANS: A Test Bank 2 Naylor’s transitional care model provided evidence that high risk older patients who had post- hospital care coordinated by an APN had reduced rehospitalization rates. It did not include clinic visits with a primary care provider, inclusion of extended family members in the plan of care, or telephone follow up by a pharmacist. REF: Transitional Care 3. Which approaches are among those recommended by the Agency for Healthcare Researchand Quality to improve health literacy in patients? Select all that apply. a. Empowering patients and families b. Giving written handouts for all teaching Buttaro: Primary Care, A Collaborative Practice, c. Highlighting no more than 7 key points d. Repeating the instructions e. Supplementing teaching with visual aids ANS: A, D, E AHRQ recommends using clear, simple language, highlighting 3 to 5 key points, using pictures or visual aids, repeating the instructions, using Teach Back, and empowering patients. Written communication is not part of the recommendations. REF: Health Literacy Test Bank 2 Chapter 3: Translating Research Into Clinical Practice Test Bank Multiple Choice 1. Which is the most appropriate research design for a Level III research study? a. Epidemiological studies b. Experimental design c. Qualitative studies d. Randomized clinical trials ANS: B The experimental design is the most appropriate design for a Level III study. Epidemiological studies are appropriate for Level II studies. Qualitative designs are useful for Level I studies. Randomized clinical trials are used for Level IV studies. REF: Level III Research/Experimental Design 2. What is the purpose of clinical research trials in the spectrum of translational research? a. Adoption of interventions and clinical practices into routine clinical care b. Determination of the basis of disease and various treatment options c. Examination of safety and effectiveness of various interventions d. Exploration of fundamental mechanisms of biology, disease, or behavior ANS: C Clinical research trials are concerned with determining the safety and effectiveness of interventions. Adoption of interventions and practices is part of clinical implementation. Determination of the basis of disease and treatment options is part of the pre-clinical Buttaro: Primary Care, A Collaborative Practice, 5 th Ed. research phase. Exploration of the fundamental mechanisms of biology, disease, or behavior is part of the basic research stage. REF: Translational Science Spectrum